Healthcare Provider Details

I. General information

NPI: 1235190711
Provider Name (Legal Business Name): CENTER FOR PHYSICAL THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 E WALNUT ST STE A
PASADENA CA
91106-1619
US

IV. Provider business mailing address

1650 E WALNUT ST STE B
PASADENA CA
91106-1619
US

V. Phone/Fax

Practice location:
  • Phone: 626-683-9959
  • Fax: 626-683-9969
Mailing address:
  • Phone: 818-731-7173
  • Fax: 626-683-9969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: RALPH SANTOS
Title or Position: ADMINISTRATOR
Credential: OTR
Phone: 818-731-7173