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General NPI Number Information
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NPI Number | 1669708384
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Entity Type | Organization
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Legal Business Name | ALFA PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 10/30/2009
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Last Update Date | 10/30/2009
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Provider Practice Location Address
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Address Line | 12832 GARDEN GROVE BLVD SUITE B
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City | GARDEN GROVE
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State | CA
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Zip | 92843-2002
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Country | US
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Telephone | 714-534-1100
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Fax | 714-534-1140
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Provider Business Mailing Address
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Address Line | 12832 GARDEN GROVE BLVD SUITE B
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City | GARDEN GROVE
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State | CA
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Zip | 92843-2002
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Country | US
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Telephone | 714-534-1100
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Fax | 714-534-1140
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. MANSOUR TAFRESHI
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Credential | D.C.
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Telephone | 714-534-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT3586
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License Number State | CA
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