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General NPI Number Information
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NPI Number | 1003867193
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Entity Type | Organization
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Legal Business Name | PHYSIOTHERAPY ASSOCIATES INC
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 2777 BRISTOL ST SUITE C
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City | COSTA MESA
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State | CA
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Zip | 92626-5997
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Country | US
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Telephone | 714-668-1600
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Fax | 714-668-1617
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Provider Business Mailing Address
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Address Line | 707 LINCOLN CTR
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City | STOCKTON
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State | CA
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Zip | 95207-2644
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Country | US
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Telephone | 209-470-5101
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Fax | 267-321-1287
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | CYNTHIA L. GOLDBERG
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Credential |
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Telephone | 610-644-7824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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