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General NPI Number Information
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NPI Number | 1922146109
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Entity Type | Organization
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Legal Business Name | FARID ZIA PHYSICAL THERAPIST A PROFESSIONAL CORP
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 1698 CRUICKSHANK DR STE A
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City | EL CENTRO
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State | CA
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Zip | 92243-1462
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Country | US
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Telephone | 760-353-3422
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Fax | 760-353-9163
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Provider Business Mailing Address
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Address Line | PO BOX 3204
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City | EL CENTRO
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State | CA
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Zip | 92244-3204
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Country | US
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Telephone | 760-353-3422
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Fax | 760-353-9163
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FARID MEMAR ZIA
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Credential | P.T.
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Telephone | 760-353-3422
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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 | PT24141
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License Number State | CA
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