Provider Demographics
NPI:1063443950
Name:LAWRENCE J. ZIPSER, P.T., INC.
Entity Type:Organization
Organization Name:LAWRENCE J. ZIPSER, P.T., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZIPSER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:562-425-9888
Mailing Address - Street 1:3816 WOODRUFF AVE
Mailing Address - Street 2:#407
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-2147
Mailing Address - Country:US
Mailing Address - Phone:562-425-9888
Mailing Address - Fax:562-425-9505
Practice Address - Street 1:3816 WOODRUFF AVE
Practice Address - Street 2:#407
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-2147
Practice Address - Country:US
Practice Address - Phone:562-425-9888
Practice Address - Fax:562-425-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT7232225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT 7232OtherPT LICENSE
CA556538Medicare Oscar/Certification
CAPT 7232OtherPT LICENSE