=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629048129
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBERT J. YAHNE, P.T. PHYSICAL THERAPY CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/25/2006
-----------------------------------------------------
Last Update Date | 06/04/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 W LACEY BLVD
-----------------------------------------------------
City | HANFORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93230-4437
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-582-2781
-----------------------------------------------------
Fax | 559-582-5985
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 401 W LACEY BLVD
-----------------------------------------------------
City | HANFORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93230-4437
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-582-2781
-----------------------------------------------------
Fax | 559-582-5985
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. ROBERT J. YAHNE
-----------------------------------------------------
Credential | P.T.
-----------------------------------------------------
Telephone | 559-582-2781
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 00PT37040
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------