Provider Demographics
NPI:1710073812
Name:PERSONAL BEST PHYSICAL THERAPY
Entity Type:Organization
Organization Name:PERSONAL BEST PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:562-402-8389
Mailing Address - Street 1:11911 ARTESIA BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90701-4065
Mailing Address - Country:US
Mailing Address - Phone:562-402-8389
Mailing Address - Fax:562-403-2638
Practice Address - Street 1:11911 ARTESIA BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90701-4065
Practice Address - Country:US
Practice Address - Phone:562-402-8389
Practice Address - Fax:562-403-2638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT10904225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT10904Medicare ID - Type UnspecifiedPHYSICAL THERAPY