Provider Demographics
NPI:1083030589
Name:NAYER PHYSICAL THERAPIST MISSION INC
Entity Type:Organization
Organization Name:NAYER PHYSICAL THERAPIST MISSION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAYER
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGHEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-905-0293
Mailing Address - Street 1:1359 HAVEN TREE LN
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-0703
Mailing Address - Country:US
Mailing Address - Phone:626-905-0293
Mailing Address - Fax:
Practice Address - Street 1:1359 HAVEN TREE LN
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-0703
Practice Address - Country:US
Practice Address - Phone:626-905-0293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-09
Last Update Date:2014-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27539253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care