Healthcare Provider Details
I. General information
NPI: 1013107093
Provider Name (Legal Business Name): TORRANCE ORTHOPEDIC PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/26/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23456 HAWTHORNE BLVD SUITE 300 B
TORRANCE CA
90505
US
IV. Provider business mailing address
23456 HAWTHORNE BLVD SUITE 300 B
TORRANCE CA
90505
US
V. Phone/Fax
- Phone: 310-540-7381
- Fax: 310-316-1788
- Phone: 310-540-7381
- Fax: 310-316-1788
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
JEANNETTE
A
ESPARZA
Title or Position: BILLING ADM
Credential:
Phone: 714-315-9654