Provider Demographics
NPI:1710622147
Name:PADILLA PHYSICAL THERAPY & FITNESS
Entity Type:Organization
Organization Name:PADILLA PHYSICAL THERAPY & FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPT
Authorized Official - Phone:661-240-8477
Mailing Address - Street 1:1627 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:WASCO
Mailing Address - State:CA
Mailing Address - Zip Code:93280-1752
Mailing Address - Country:US
Mailing Address - Phone:661-240-8477
Mailing Address - Fax:
Practice Address - Street 1:1627 SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-1752
Practice Address - Country:US
Practice Address - Phone:661-240-8477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-30
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty