Provider Demographics
NPI:1346271350
Name:UNICARE PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:UNICARE PHYSICAL THERAPY, INC.
Other - Org Name:UNICARE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENN
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:949-857-2221
Mailing Address - Street 1:14785 JEFFREY RD
Mailing Address - Street 2:# 108
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-0408
Mailing Address - Country:US
Mailing Address - Phone:949-857-2221
Mailing Address - Fax:
Practice Address - Street 1:14785 JEFFREY RD
Practice Address - Street 2:# 108
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-0408
Practice Address - Country:US
Practice Address - Phone:949-857-2221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW 14461 AMedicare ID - Type UnspecifiedPHYSICAL THERAPY GROUP