Healthcare Provider Details

I. General information

NPI: 1992747380
Provider Name (Legal Business Name): PHYSICAL MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 11/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 NOTRE DAME BLVD SUITE 120
CHICO CA
95928-6814
US

IV. Provider business mailing address

2000 NOTRE DAME BLVD SUITE 120
CHICO CA
95928-6895
US

V. Phone/Fax

Practice location:
  • Phone: 530-898-9850
  • Fax: 530-898-9860
Mailing address:
  • Phone: 530-898-9850
  • Fax: 530-898-9860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JANNA P. KING
Title or Position: VP/AUTHORIZED OFFICIAL
Credential: JD
Phone: 713-297-7000