Provider Demographics
NPI:1558323469
Name:INTEGRATED PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:INTEGRATED PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEETA
Authorized Official - Middle Name:GURMEET
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:949-280-8261
Mailing Address - Street 1:303 BROADWAY ST STE 211
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-1816
Mailing Address - Country:US
Mailing Address - Phone:949-280-8261
Mailing Address - Fax:949-305-8467
Practice Address - Street 1:303 BROADWAY ST STE 211
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-1816
Practice Address - Country:US
Practice Address - Phone:949-280-8261
Practice Address - Fax:949-305-8467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17103Medicare ID - Type UnspecifiedGROUP MEDICARE ID NUMBER