Healthcare Provider Details

I. General information

NPI: 1538928494
Provider Name (Legal Business Name): SANA PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8035 E BROWN RD
MESA AZ
85207-3901
US

IV. Provider business mailing address

3452 E FOOTHILL BLVD STE 720
PASADENA CA
91107-6031
US

V. Phone/Fax

Practice location:
  • Phone: 480-686-8540
  • Fax: 480-686-8022
Mailing address:
  • Phone: 626-796-8700
  • Fax: 626-568-6573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: GARY LANGENDOEN
Title or Position: MANAGER
Credential:
Phone: 626-796-8700