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General NPI Number Information
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NPI Number | 1437464096
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Entity Type | Organization
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Legal Business Name | SOFT PHYSICAL THERAPY
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Dates
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Enumeration Date | 08/07/2010
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Last Update Date | 08/07/2010
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Provider Practice Location Address
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Address Line | 2010 WILSHIRE BLVD SUITE 404
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City | LOS ANGELES
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State | CA
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Zip | 90057-3507
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Country | US
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Telephone | 213-484-6666
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Fax | 213-484-9999
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Provider Business Mailing Address
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Address Line | 2010 WILSHIRE BLVD SUITE 404
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City | LOS ANGELES
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State | CA
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Zip | 90057-3507
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Country | US
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Telephone | 213-484-6666
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Fax | 213-484-9999
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIO C HINOJOSA
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Credential | RPT
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Telephone | 213-484-6666
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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 | PT7940
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License Number State | CA
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