Provider Demographics
NPI:1518616960
Name:THE PHYSICAL THERAPY COLLABORATIVE, A CALIFORNIA CORP.
Entity Type:Organization
Organization Name:THE PHYSICAL THERAPY COLLABORATIVE, A CALIFORNIA CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CHI YEH
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:818-405-0800
Mailing Address - Street 1:13320 RIVERSIDE DR STE 208
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2512
Mailing Address - Country:US
Mailing Address - Phone:818-405-0800
Mailing Address - Fax:818-405-0801
Practice Address - Street 1:13320 RIVERSIDE DR STE 208
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2512
Practice Address - Country:US
Practice Address - Phone:818-405-0800
Practice Address - Fax:818-405-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty