Provider Demographics
NPI:1699198713
Name:ADVENT PHYSICAL THERAPY GROUP, PC
Entity Type:Organization
Organization Name:ADVENT PHYSICAL THERAPY GROUP, PC
Other - Org Name:ABILITY REHABILITATION SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:SARMIENTO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:858-456-2114
Mailing Address - Street 1:737 PEARL ST
Mailing Address - Street 2:108
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-0056
Mailing Address - Country:US
Mailing Address - Phone:858-456-2114
Mailing Address - Fax:858-456-2103
Practice Address - Street 1:737 PEARL ST
Practice Address - Street 2:108
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-0056
Practice Address - Country:US
Practice Address - Phone:858-456-2114
Practice Address - Fax:858-456-2103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy