Provider Demographics
NPI:1720009186
Name:MOBILE THERAPISTS INC
Entity Type:Organization
Organization Name:MOBILE THERAPISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PARISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAHANCHI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:760-809-6739
Mailing Address - Street 1:259 CAMINO TABLERO
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-7444
Mailing Address - Country:US
Mailing Address - Phone:760-291-0074
Mailing Address - Fax:760-291-0076
Practice Address - Street 1:651 E PENNSYLVANIA AVENUE
Practice Address - Street 2:STE 202
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3053
Practice Address - Country:US
Practice Address - Phone:760-291-0074
Practice Address - Fax:760-291-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA796224Z00000X
CAPT17606225100000X
CAPT18929225100000X
CAPT29902225100000X
CAAT701225200000X
CAAT4366225200000X
CAOT2783225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADD0582OtherRAILROAD MEDICARE
CADD0582OtherRAILROAD MEDICARE