Healthcare Provider Details

I. General information

NPI: 1366500597
Provider Name (Legal Business Name): VERTEX PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 SEQUOIA AVE
SIMI VALLEY CA
93063-3167
US

IV. Provider business mailing address

1115 E LOS ANGELES AVE
SIMI VALLEY CA
93065-2801
US

V. Phone/Fax

Practice location:
  • Phone: 805-306-0070
  • Fax:
Mailing address:
  • Phone: 805-306-1840
  • Fax: 180-099-6475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. PAUL LEFKO
Title or Position: CEO
Credential: PT
Phone: 805-306-0070