Provider Demographics
NPI:1164445565
Name:SIMS PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:SIMS PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:QUENTIN
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:805-928-4465
Mailing Address - Street 1:2530 PROFESSIONAL PKWY
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-1602
Mailing Address - Country:US
Mailing Address - Phone:805-928-4465
Mailing Address - Fax:
Practice Address - Street 1:2530 PROFESSIONAL PKWY
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1602
Practice Address - Country:US
Practice Address - Phone:805-928-4465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGPT001690OtherSTATE MEDI-CAL PT GROUP #
CAZZZ52509ZOtherBLUE SHIELD PT GROUP #
CAZZZ65900ZOtherBLUE SHIELD OT GROUP #
CA0161641OtherCIGNA PROVIDER #
CAGCT000560OtherSTATE MEDI-CAL OT GROUP #
CA4464320001Medicare NSC
CAW14798Medicare ID - Type UnspecifiedGROUP PROVIDER #