Provider Demographics
NPI:1033105523
Name:HARRIS & KING HEALTH SERVICES INC
Entity Type:Organization
Organization Name:HARRIS & KING HEALTH SERVICES INC
Other - Org Name:DOS CAMINOS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:KING
Authorized Official - Suffix:II
Authorized Official - Credentials:PHD PT
Authorized Official - Phone:805-484-5447
Mailing Address - Street 1:2486 N PONDEROSA DR
Mailing Address - Street 2:SUITE D106
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-2376
Mailing Address - Country:US
Mailing Address - Phone:805-484-5447
Mailing Address - Fax:805-484-2158
Practice Address - Street 1:2486 N PONDEROSA DR
Practice Address - Street 2:SUITE D106
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-2376
Practice Address - Country:US
Practice Address - Phone:805-484-5447
Practice Address - Fax:805-484-2158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-21
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
W14769Medicare ID - Type Unspecified