MEDICARE: BIOMOTION 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
1	225100000X	Physical Therapist	PT28530	CA
2	225100000X	Physical Therapist	PT32476	CA
3	225100000X	Physical Therapist	PT27148	CA
4	225100000X	Physical Therapist	PT19246	CA

General Provider Information

NPI Number	:	1497780431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIOMOTION PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	1407 E LOS ANGELES AVE
Second Line	:	STE. K
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-2863
Country	:	US
Telephone Number	:	805-583-2400
Fax Number	:	805-583-2404

Provider Business Practice Location Address
First Line	:	1407 E LOS ANGELES AVE
Second Line	:	STE. K
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-2863
Country	:	US
Telephone Number	:	805-583-2400
Fax Number	:	805-583-2404

Authorized Official
Title or Position	:	OWNER
Name	:	DAVE FACIANA
Credential	:	PT, OCS, SCS, CSCS
Telephone Number	:	805-583-2400

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	08/22/2020

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