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General NPI Number Information
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NPI Number | 1609929256
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Entity Type | Organization
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Legal Business Name | PACIFIC PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 04/13/2010
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Provider Practice Location Address
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Address Line | 550 DEEP VALLEY DR SUITE 297
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City | ROLLING HILLS ESTATES
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State | CA
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Zip | 90274-3664
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Country | US
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Telephone | 310-544-6264
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Fax |
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Provider Business Mailing Address
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Address Line | 550 DEEP VALLEY DR SUITE 297
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City | ROLLING HILLS ESTATES
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State | CA
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Zip | 90274-3664
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Country | US
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Telephone | 310-544-6264
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK ARGENTO
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Credential | RPT
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Telephone | 310-544-6264
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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 | PT23163
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License Number State | CA
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