Provider Demographics
NPI:1508936626
Name:COMPLETE BALANCE SOLUTION INSTITUTE OF PHYSIOTHERAPY INC
Entity Type:Organization
Organization Name:COMPLETE BALANCE SOLUTION INSTITUTE OF PHYSIOTHERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAPAN
Authorized Official - Middle Name:NARESH
Authorized Official - Last Name:PALKHIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:949-340-6927
Mailing Address - Street 1:24422 AVENIDA DE LA CARLOTA
Mailing Address - Street 2:SUITE 190
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7602
Mailing Address - Country:US
Mailing Address - Phone:949-340-6927
Mailing Address - Fax:949-215-7246
Practice Address - Street 1:24422 AVENIDA DE LA CARLOTA
Practice Address - Street 2:SUITE 190
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7602
Practice Address - Country:US
Practice Address - Phone:949-340-6927
Practice Address - Fax:949-215-7246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26543225100000X, 2251G0304X, 2251N0400X
CAPT27537225100000X, 2251G0304X, 2251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT27537AOtherPPIN
CAWPT26543OtherPPIN
CAQ63152Medicare UPIN
CA6215970001Medicare NSC
6215970001Medicare NSC
CAWPT26543OtherPPIN
CAWPT27537AOtherPPIN
Q63153Medicare UPIN
CAWPT26543OtherPPIN