Provider Demographics
NPI:1003824137
Name:TWIN OAKS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:TWIN OAKS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MASTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:760-752-8678
Mailing Address - Street 1:120 CRAVEN RD
Mailing Address - Street 2:SUITE NUMBER 109
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-4235
Mailing Address - Country:US
Mailing Address - Phone:760-752-8678
Mailing Address - Fax:760-471-7928
Practice Address - Street 1:120 CRAVEN RD
Practice Address - Street 2:SUITE NUMBER 109
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-4235
Practice Address - Country:US
Practice Address - Phone:760-752-8678
Practice Address - Fax:760-471-7928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16344Medicare ID - Type Unspecified