Provider Demographics
NPI:1699030239
Name:ADVANCED PHYSICAL THERAPY & ERGONOMICS INC
Entity Type:Organization
Organization Name:ADVANCED PHYSICAL THERAPY & ERGONOMICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, ATC
Authorized Official - Phone:925-222-3195
Mailing Address - Street 1:3128 SANTA RITA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-8300
Mailing Address - Country:US
Mailing Address - Phone:925-222-3195
Mailing Address - Fax:925-891-7870
Practice Address - Street 1:3128 SANTA RITA RD
Practice Address - Street 2:SUITE B
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-8300
Practice Address - Country:US
Practice Address - Phone:925-222-3195
Practice Address - Fax:925-891-7870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18170261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGP689AMedicare PIN