Healthcare Provider Details

I. General information

NPI: 1669787495
Provider Name (Legal Business Name): ARROYO PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 E WASHINGTON BLVD 208
PASADENA CA
91104-2779
US

IV. Provider business mailing address

12241 INDUSTRIAL BLVD STE 210
VICTORVILLE CA
92395-8301
US

V. Phone/Fax

Practice location:
  • Phone: 626-593-2283
  • Fax: 626-593-2284
Mailing address:
  • Phone: 800-489-6905
  • Fax: 800-489-6905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT37027
License Number StateCA

VIII. Authorized Official

Name: DR. GREGORY COX
Title or Position: CEO
Credential: PT, DPT
Phone: 323-401-1408