Provider Demographics
NPI:1225502842
Name:TRANSFORMATION PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:TRANSFORMATION PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:626-378-1529
Mailing Address - Street 1:10 W PALM DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-5144
Mailing Address - Country:US
Mailing Address - Phone:626-378-1529
Mailing Address - Fax:
Practice Address - Street 1:10 W PALM DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-5144
Practice Address - Country:US
Practice Address - Phone:626-378-1529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty