Healthcare Provider Details

I. General information

NPI: 1740427673
Provider Name (Legal Business Name): PARISA REFAAT PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2009
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4028 E BROADWAY
LONG BEACH CA
90803-1502
US

IV. Provider business mailing address

4028 E BROADWAY
LONG BEACH CA
90803-1502
US

V. Phone/Fax

Practice location:
  • Phone: 562-433-4331
  • Fax: 562-433-4336
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number34230
License Number StateCA

VIII. Authorized Official

Name: DR. PARISA REFAAT
Title or Position: CEO/OWNER
Credential: DPT
Phone: 562-433-4331