Provider Demographics
NPI:1235190711
Name:CENTER FOR PHYSICAL THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:CENTER FOR PHYSICAL THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:818-731-7173
Mailing Address - Street 1:1650 E WALNUT ST STE B
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1619
Mailing Address - Country:US
Mailing Address - Phone:818-731-7173
Mailing Address - Fax:626-683-9969
Practice Address - Street 1:1650 E WALNUT ST
Practice Address - Street 2:STE A
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1619
Practice Address - Country:US
Practice Address - Phone:626-683-9959
Practice Address - Fax:626-683-9969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2023-06-07
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
CAW15968Medicare PIN