Healthcare Provider Details

I. General information

NPI: 1053704098
Provider Name (Legal Business Name): ALPHA PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2015
Last Update Date: 03/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11374 MOUNTAIN VIEW AVE # A1
LOMA LINDA CA
92354-3830
US

IV. Provider business mailing address

25612 BARTON RD # 362
LOMA LINDA CA
92354-3110
US

V. Phone/Fax

Practice location:
  • Phone: 909-771-4355
  • Fax:
Mailing address:
  • Phone: 909-771-4355
  • Fax:

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: MR. PETER MASIH AZIZ
Title or Position: DIRECTOR OF PHYSICAL THERAPY
Credential: P.T.
Phone: 909-252-6334