Provider Demographics
NPI:1639377799
Name:MONTEREY ORTHOPEDIC PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MONTEREY ORTHOPEDIC PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PAVLET
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:831-373-7168
Mailing Address - Street 1:157 SARGENT CT
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3115
Mailing Address - Country:US
Mailing Address - Phone:831-373-7168
Mailing Address - Fax:831-373-7299
Practice Address - Street 1:157 SARGENT CT
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3115
Practice Address - Country:US
Practice Address - Phone:831-373-7168
Practice Address - Fax:831-373-7299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT16103225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ29578ZMedicare PIN