Provider Demographics
NPI:1528194313
Name:HEALTHPOINTE MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:HEALTHPOINTE MEDICAL GROUP, INC.
Other - Org Name:TRAC PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:714-635-2642
Mailing Address - Street 1:16702 VALLEY VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-5824
Mailing Address - Country:US
Mailing Address - Phone:714-367-5391
Mailing Address - Fax:714-635-5428
Practice Address - Street 1:754 N MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-2544
Practice Address - Country:US
Practice Address - Phone:909-460-4155
Practice Address - Fax:909-988-4414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ43056ZMedicare PIN
CAZZZ45836ZMedicare PIN