Provider Demographics
NPI:1467897371
Name:XCEL, PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:XCEL, PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:LUCAS
Authorized Official - Last Name:DREITH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-531-2002
Mailing Address - Street 1:1329 LUSITANA STREET
Mailing Address - Street 2:SUITE 501
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2412
Mailing Address - Country:US
Mailing Address - Phone:808-531-2002
Mailing Address - Fax:808-566-0375
Practice Address - Street 1:1329 LUSITANA STREET
Practice Address - Street 2:SUITE 501
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2412
Practice Address - Country:US
Practice Address - Phone:808-531-2002
Practice Address - Fax:808-566-0375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIP.T.872225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI51360Medicare UPIN