Provider Demographics
NPI:1164526208
Name:MJ PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:MJ PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:STEINER
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:760-941-8600
Mailing Address - Street 1:1830 HACIENDA DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081
Mailing Address - Country:US
Mailing Address - Phone:760-941-8600
Mailing Address - Fax:760-941-1220
Practice Address - Street 1:1830 HACIENDA DR
Practice Address - Street 2:SUITE 2
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081
Practice Address - Country:US
Practice Address - Phone:760-941-8600
Practice Address - Fax:760-941-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2008-04-02
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
CAW21100Medicare PIN