Provider Demographics
NPI:1689846099
Name:JOSE RECASAS PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:JOSE RECASAS PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:C
Authorized Official - Last Name:RECASAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:213-382-0560
Mailing Address - Street 1:266 S HARVARD BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-4372
Mailing Address - Country:US
Mailing Address - Phone:213-382-0560
Mailing Address - Fax:
Practice Address - Street 1:266 S HARVARD BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-4372
Practice Address - Country:US
Practice Address - Phone:213-382-0560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty