Provider Demographics
NPI:1508964685
Name:RODNEY K. SHOREY PHYSICAL THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:RODNEY K. SHOREY PHYSICAL THERAPY SERVICES, INC.
Other - Org Name:WOODLAND HILLS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHOREY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:310-923-5440
Mailing Address - Street 1:22151 CLARENDON ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6308
Mailing Address - Country:US
Mailing Address - Phone:818-884-4810
Mailing Address - Fax:818-884-4802
Practice Address - Street 1:22151 CLARENDON ST
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6308
Practice Address - Country:US
Practice Address - Phone:818-884-4810
Practice Address - Fax:818-884-4802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT22464225100000X
225100000X
CAPT224622251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20130Medicare PIN