Provider Demographics
NPI:1801025572
Name:WATER PT SPECIALISTS INC
Entity Type:Organization
Organization Name:WATER PT SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-991-7751
Mailing Address - Street 1:PO BOX 1249
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-0249
Mailing Address - Country:US
Mailing Address - Phone:310-991-7751
Mailing Address - Fax:310-881-1219
Practice Address - Street 1:8015 S SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-2940
Practice Address - Country:US
Practice Address - Phone:310-991-7751
Practice Address - Fax:310-881-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25373225100000X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT25373OtherCA LICENCE