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NPI Code Detail

MEDICARE: ONE STEP AHEAD PEDIATRIC PHYSICAL THERAPY

MEDICARE: ONE STEP AHEAD PEDIATRIC PHYSICAL THERAPY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/CenterPT25103CA

General Provider Information

NPI Number : 1114257474
Entity Type Code : Organization
Provider Name (Legal Business Name) : ONE STEP AHEAD PEDIATRIC PHYSICAL THERAPY
Provider Business Mailing Address
First Line : 6962 W 85TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-2603
Country : US
Telephone Number : 310-890-7584
Fax Number : 310-642-1195
Provider Business Practice Location Address
First Line : 150 SIERRA ST
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-4117
Country : US
Telephone Number : 310-890-7584
Fax Number : 310-642-1195
Authorized Official
Title or Position : CEO/PHYSICAL TEHRAPIST
Name : MRS. LISA BRADFORD ULRICH
Credential : PT
Telephone Number : 310-890-7584
Provider Enumeration Date : 01/10/2010
Last Update Date : 01/10/2010

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Directions to “ONE STEP AHEAD PEDIATRIC PHYSICAL THERAPY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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