Provider Demographics
NPI:1023215530
Name:STAY READY PHYSICAL THERAPY
Entity Type:Organization
Organization Name:STAY READY PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-936-7525
Mailing Address - Street 1:11819 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6619
Mailing Address - Country:US
Mailing Address - Phone:323-936-7525
Mailing Address - Fax:323-936-7572
Practice Address - Street 1:11819 WILSHIRE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6619
Practice Address - Country:US
Practice Address - Phone:323-936-7525
Practice Address - Fax:323-936-7572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT287572251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT28757OtherPHYSICAL THERAPY LICENSE