Healthcare Provider Details
I. General information
NPI: 1982996377
Provider Name (Legal Business Name): UNIFIED PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2011
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3800 E ANAHEIM ST
LONG BEACH CA
90804-4005
US
IV. Provider business mailing address
2666 E ADAMS ST
CARSON CA
90810-1503
US
V. Phone/Fax
- Phone: 562-316-6758
- Fax: 562-961-8205
- Phone: 562-316-6758
- Fax: 562-961-8205
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EVANGELINE
P
PATEL
Title or Position: PRESIDENT
Credential: P.T.
Phone: 562-316-6758