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General NPI Number Information
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NPI Number | 1124150909
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Entity Type | Organization
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Legal Business Name | PASADENA PHYSICAL THERAPY ASSOCIATES
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 09/26/2007
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Provider Practice Location Address
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Address Line | 615 E UNION ST
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City | PASADENA
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State | CA
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Zip | 91101-1719
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Country | US
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Telephone | 626-304-0565
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Fax | 626-304-0528
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Provider Business Mailing Address
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Address Line | 615 E UNION ST
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City | PASADENA
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State | CA
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Zip | 91101-1719
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Country | US
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Telephone | 626-304-0565
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Fax | 626-304-0528
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Authorized Official
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Title or Position | OWNER
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Name | LOCATELLI RAO
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Credential | DPT
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Telephone | 626-304-0565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT27694
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License Number State | CA
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