Provider Demographics
NPI:1790706919
Name:GLINN AND GIORDANO PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:GLINN AND GIORDANO PHYSICAL THERAPY INC.
Other - Org Name:MARIE GLYNN OCCUPATIONAL THERAPY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-327-4357
Mailing Address - Street 1:1201 23RD STREET
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301
Mailing Address - Country:US
Mailing Address - Phone:661-327-4357
Mailing Address - Fax:661-327-2311
Practice Address - Street 1:1831 TRUXTUN AVE STE 150
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5026
Practice Address - Country:US
Practice Address - Phone:661-326-1433
Practice Address - Fax:661-326-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CAOT538225X00000X
9105000422225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21295ZOtherMEDICARE PTAN
CA6077220001Medicare NSC
CAZZZ73743ZMedicare ID - Type Unspecified