Provider Demographics
NPI:1437464096
Name:SOFT PHYSICAL THERAPY
Entity Type:Organization
Organization Name:SOFT PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:HINOJOSA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:213-484-6666
Mailing Address - Street 1:2010 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3507
Mailing Address - Country:US
Mailing Address - Phone:213-484-6666
Mailing Address - Fax:213-484-9999
Practice Address - Street 1:2010 WILSHIRE BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3507
Practice Address - Country:US
Practice Address - Phone:213-484-6666
Practice Address - Fax:213-484-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-07
Last Update Date:2010-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT7940225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty