MEDICARE: RANCHO PHYSICAL THERAPY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912288309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RANCHO PHYSICAL THERAPY, INC.

Provider Business Mailing Address
First Line	:	30428 HAUN RD STE 810
Second Line	:
City	:	MENIFEE
State	:	CA
Zip	:	92584-6824
Country	:	US
Telephone Number	:	951-696-9353
Fax Number	:	951-973-7216

Provider Business Practice Location Address
First Line	:	6850 BROCKTON AVE STE 212
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-3815
Country	:	US
Telephone Number	:	951-534-0600
Fax Number	:	951-534-0605

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	GABRIELA LITT
Credential	:
Telephone Number	:	951-696-9353

Provider Enumeration Date	:	08/30/2011
Last Update Date	:	12/12/2025

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