Provider Demographics
NPI:1174648554
Name:BALANCE PHYSICAL THERAPY & HUMAN PERFORMANCE CENTER, INC
Entity Type:Organization
Organization Name:BALANCE PHYSICAL THERAPY & HUMAN PERFORMANCE CENTER, INC
Other - Org Name:BALANCE PHYSICAL THERAPY & HUMAN PERFORMANCE CENTER, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHNATHAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:FARAHMAND
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:831-422-4782
Mailing Address - Street 1:143 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3337
Mailing Address - Country:US
Mailing Address - Phone:831-422-4782
Mailing Address - Fax:831-422-4784
Practice Address - Street 1:143 JOHN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3337
Practice Address - Country:US
Practice Address - Phone:831-422-4782
Practice Address - Fax:831-422-4784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2023-04-07
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ28500ZMedicare PIN
CAP53872Medicare UPIN