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Ivan Vivanco
Rehabilitation Practitioner in Chatsworth, California
NPI 1700423712

Ivan Vivanco is a Rehabilitation Practitioner based in Chatsworth, CA. Ivan Vivanco practices in Chatsworth, CA. The NPI Number for Ivan Vivanco is 1700423712 and holds a License No. (California).

The current practice location address for Ivan Vivanco is 21000 Plummer St, Chatsworth, CA and can be reached out via phone at 661-348-5492.

Location: 21000 Plummer St, Chatsworth, CA, 91311-4903
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700423712
Provider Name
Ivan Vivanco
Credential
Provider Entity Type
Individual
Gender
Male
Address
21000 Plummer St, Chatsworth, CA, 91311-4903
Phone Number
661-348-5492
Fax Number
Provider Enumeration Date
12/09/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
21000 Plummer St
City
Chatsworth
State
California
Zip
91311-4903
Phone Number
661-348-5492
Fax Number
person
Provider Business Mailing Address Details
Address
21000 Plummer St
City
Chatsworth
State
California
Zip
91311-4903
Phone Number
661-348-5492
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Rehabilitation Practitioner
Speciality
-
Taxonomy
225400000X
License No.
()
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
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