Healthcare Provider Details

I. General information

NPI: 1487889283
Provider Name (Legal Business Name): BIOMECHANICS PHYSICAL THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 04/02/2020
Certification Date: 04/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1886 NOWAK AVE
THOUSAND OAKS CA
91360-3334
US

IV. Provider business mailing address

1886 NOWAK AVE
THOUSAND OAKS CA
91360-3334
US

V. Phone/Fax

Practice location:
  • Phone: 323-786-1890
  • Fax: 323-798-1792
Mailing address:
  • Phone: 323-786-1890
  • Fax: 323-798-1792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT 93861
License Number StateCA

VIII. Authorized Official

Name: DR. DOUGLAS STEVEN TURNER
Title or Position: ADMINISTRATOR / PRESIDENT
Credential: P.T., D.P.T.
Phone: 323-786-1890