Provider Demographics
NPI:1073650834
Name:HUNTINGTON BEACH PHYSICAL THERAPY SPECIALIST A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:HUNTINGTON BEACH PHYSICAL THERAPY SPECIALIST A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RISHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:STROPLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:714-841-6162
Mailing Address - Street 1:19582 BEACH BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2996
Mailing Address - Country:US
Mailing Address - Phone:714-841-6162
Mailing Address - Fax:714-841-9912
Practice Address - Street 1:19582 BEACH BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2996
Practice Address - Country:US
Practice Address - Phone:714-841-6162
Practice Address - Fax:714-841-9912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2015-04-17
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
CA1770730673OtherNPI SS
CA1629234414OtherNPI
CA1790931350OtherNPI
CA1629234414OtherNPI
CA1790931350OtherNPI