Provider Demographics
NPI:1508183518
Name:UNITED THERAPY NETWORK INCORPORATED
Entity Type:Organization
Organization Name:UNITED THERAPY NETWORK INCORPORATED
Other - Org Name:UNITED THERAPY NETWORK, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUDMUNDUR
Authorized Official - Middle Name:HEIMIR
Authorized Official - Last Name:GUNNARSSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:909-890-9030
Mailing Address - Street 1:1845 BUSINESS CENTER DR STE 127
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3434
Mailing Address - Country:US
Mailing Address - Phone:909-890-9030
Mailing Address - Fax:909-890-4393
Practice Address - Street 1:1845 BUSINESS CENTER DR
Practice Address - Street 2:SUITE 127
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3467
Practice Address - Country:US
Practice Address - Phone:909-890-9030
Practice Address - Fax:909-890-4393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X, 225X00000X, 225100000X
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
CAZZZ21182ZMedicare PIN