Provider Demographics
NPI:1215004684
Name:ANN BASS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ANN BASS PHYSICAL THERAPY
Other - Org Name:DOWNTOWN PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:213-689-1679
Mailing Address - Street 1:626 WILSHIRE BLVD STE 460
Mailing Address - Street 2:SUITE 460
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-2917
Mailing Address - Country:US
Mailing Address - Phone:213-689-1679
Mailing Address - Fax:213-689-1084
Practice Address - Street 1:626 WILSHIRE BLVD STE 460
Practice Address - Street 2:SUITE 460
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2917
Practice Address - Country:US
Practice Address - Phone:213-689-1679
Practice Address - Fax:213-689-1084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT6793225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty