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NPI 1588088611

NPI 1588088611 : PASADENA PHYSICAL THERAPY, PC : PASADENA, CA

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General NPI Number Information
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    NPI Number           |    1588088611
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    Entity Type          |    Organization 
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    Legal Business Name  |    PASADENA PHYSICAL THERAPY, PC 
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Dates
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    Enumeration Date     |    02/10/2014
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    Last Update Date     |    02/10/2014
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Provider Practice Location Address
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    Address Line         |    95 W CALIFORNIA BLVD 
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    City                 |    PASADENA
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    State                |    CA
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    Zip                  |    91105-3026
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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         |    95 W CALIFORNIA BLVD 
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    City                 |    PASADENA
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    State                |    CA
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    Zip                  |    91105-3026
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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       |    
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    License Number State |    
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