Provider Demographics
NPI:1952504078
Name:EXERCISING ENTERPRISES
Entity Type:Organization
Organization Name:EXERCISING ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OBENAUS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:310-871-6762
Mailing Address - Street 1:915C W FOOTHILL BLVD # 564
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3304
Mailing Address - Country:US
Mailing Address - Phone:310-871-6762
Mailing Address - Fax:909-593-4883
Practice Address - Street 1:915C W FOOTHILL BLVD # 564
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3304
Practice Address - Country:US
Practice Address - Phone:310-871-6762
Practice Address - Fax:909-593-4883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1942313846OtherNPI NUMBER FOR INDIVIDUAL
CAPT13224Medicare ID - Type Unspecified
CAQ36349Medicare UPIN