Provider Demographics
NPI:1558343038
Name:GROVE, ANDERSEN, GHIRINGHELLI PHYSICAL THERAPY A PROFESSIONAL CO
Entity Type:Organization
Organization Name:GROVE, ANDERSEN, GHIRINGHELLI PHYSICAL THERAPY A PROFESSIONAL CO
Other - Org Name:GROVE ANDERSEN GHIRINGHELLI PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZITTERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-602-4106
Mailing Address - Street 1:860 SOUTHAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-1907
Mailing Address - Country:US
Mailing Address - Phone:707-745-6144
Mailing Address - Fax:707-745-5698
Practice Address - Street 1:860 SOUTHAMPTON RD
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-1907
Practice Address - Country:US
Practice Address - Phone:707-745-6144
Practice Address - Fax:707-745-5698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ25256ZMedicare PIN