Healthcare Provider Details

I. General information

NPI: 1881542132
Provider Name (Legal Business Name): MICHAEL HADI PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 ROYALTY DR STE 220
POMONA CA
91767-3056
US

IV. Provider business mailing address

1845 BUSINESS CENTER DR STE 127
SAN BERNARDINO CA
92408-3434
US

V. Phone/Fax

Practice location:
  • Phone: 909-622-0006
  • Fax: 909-622-0007
Mailing address:
  • Phone: 909-890-9030
  • Fax: 909-890-4393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number309777
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: