Basic Information
| Provider Information | |||||||||
| NPI: | 1679515266 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ORDAS | ||||||||
| FirstName: | TAMARA | ||||||||
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| Credential: | PT, DPT, MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7055 W BELL RD | ||||||||
| Address2: | STE 1 | ||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853088545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098243918 | ||||||||
| FaxNumber: | 9498618601 | ||||||||
| Practice Location | |||||||||
| Address1: | 17332 VON KARMAN AVE | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926146242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9498618600 | ||||||||
| FaxNumber: | 9498618601 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2006 | ||||||||
| LastUpdateDate: | 05/03/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT29101 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.