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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

ANOCHA SUPHOL, MPT
4444 MAGNOLIA AVE
RIVERSIDE, CA92501-4136
 Phone: 951-274-3524
 Fax: 951-274-3442
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type
 

Orthopedic

2251X0800X 65 Physical Therapist in Private Practice
 

Sports

2251S0007X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for ANOCHA SUPHOL · (Male)

NPI Number 1003031899
Status Active
Credentials MPT (Master of Physical Therapy)
Entity Individual
Enumeration date 04/16/2007
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • CA License # PT27871
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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