Provider Demographics
NPI:1578548749
Name:SAVARESE, THOMAS A (PT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:A
Last Name:SAVARESE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 CARSON HILL CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-4330
Mailing Address - Country:US
Mailing Address - Phone:661-664-7788
Mailing Address - Fax:
Practice Address - Street 1:4200 BUCK OWENS BLVD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-4935
Practice Address - Country:US
Practice Address - Phone:661-633-2125
Practice Address - Fax:661-348-4784
Is Sole Proprietor?:No
Enumeration Date:2005-12-10
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT179972251E1200X, 2251G0304X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT179970Medicare ID - Type UnspecifiedPHYSICAL THERAPY