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General NPI Number Information
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NPI Number | 1467605832
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Entity Type | Organization
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Legal Business Name | S K CALLAHAN, PHYSICAL THERAPIST, INC.
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | 2006 SCARBOROUGH LN
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City | SAN DIMAS
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State | CA
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Zip | 91773-3740
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Country | US
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Telephone | 626-974-5665
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Fax | 626-974-5665
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Provider Business Mailing Address
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Address Line | 1136 VIA VERDE 502
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City | SAN DIMAS
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State | CA
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Zip | 91773-4401
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Country | US
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Telephone | 626-974-5665
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Fax | 626-974-5665
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SEAN KEVIN CALLAHAN
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Credential | M.P.T.
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Telephone | 626-974-5665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PT25293
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License Number State | CA
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