Provider Demographics
NPI:1487829511
Name:RAMON LOPEZ PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:RAMON LOPEZ PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:P
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:310-478-8885
Mailing Address - Street 1:1426 AVIATION BLVD
Mailing Address - Street 2:STE 204
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4002
Mailing Address - Country:US
Mailing Address - Phone:310-478-8885
Mailing Address - Fax:
Practice Address - Street 1:1426 AVIATION BLVD
Practice Address - Street 2:STE 204
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-4002
Practice Address - Country:US
Practice Address - Phone:310-478-8885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty