LEANDRO MODENESE BASTOS

ALL STAR PHYSICAL THERAPY INC

Dr LEANDRO MODENESE BASTOS is a male medical professional, specializing in Physical Therapy. He graduated in 2018.

Contact

ALL STAR PHYSICAL THERAPY INC

425 DIAMOND DR
SUITE 101
LAKE ELSINORE
CA
925304495

Tel: 9516749515

LEANDRO MODENESE BASTOS Information

Npi 1679045546
Pac Id 4082952452
Professional Enrollment Id I20190208002596
Last Name BASTOS
First Name LEANDRO
Middle Name MODENESE
Suffix
Gender M
Credential
Medical School Name OTHER
Graduation Year 2018
Primary Specialty PHYSICAL THERAPY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name ALL STAR PHYSICAL THERAPY INC
Group Practice Pac Id 7719030949
Number Of Group Practice Members 62
Line 1 Street Address 425 DIAMOND DR
Line 2 Street Address SUITE 101
Marker Of Address Line 2 Suppression
City LAKE ELSINORE
State CA
Zip Code 925304495
Phone Number 9516749515
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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