Provider Demographics
NPI:1205966520
Name:THERAPEUTIC HANDS ORTHOPEDIC HOME PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:THERAPEUTIC HANDS ORTHOPEDIC HOME PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EYTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:858-335-5658
Mailing Address - Street 1:11422 HOLLY FERN CT.
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131
Mailing Address - Country:US
Mailing Address - Phone:858-335-5658
Mailing Address - Fax:858-578-5759
Practice Address - Street 1:11422 HOLLY FERN CT.
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131
Practice Address - Country:US
Practice Address - Phone:858-335-5658
Practice Address - Fax:858-578-5759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT21745174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW21253OtherPTAN