Provider Demographics
NPI:1720033707
Name:BARTON PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:BARTON PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:818-575-9072
Mailing Address - Street 1:28720 ROADSIDE DR
Mailing Address - Street 2:#149
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-3316
Mailing Address - Country:US
Mailing Address - Phone:818-575-9072
Mailing Address - Fax:818-575-9011
Practice Address - Street 1:28720 ROADSIDE DR
Practice Address - Street 2:#149
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-3316
Practice Address - Country:US
Practice Address - Phone:818-575-9072
Practice Address - Fax:818-575-9011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26103225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18877Medicare ID - Type UnspecifiedGROUP