Provider Demographics
NPI:1265478358
Name:CRS PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:CRS PHYSICAL THERAPY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER /OPERATOR, PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FARSHID
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAJZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:858-866-0340
Mailing Address - Street 1:4501 MISSION BAY DRIVE
Mailing Address - Street 2:SUITE 3K
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109
Mailing Address - Country:US
Mailing Address - Phone:858-866-0340
Mailing Address - Fax:858-866-0342
Practice Address - Street 1:4501 MISSION BAY DR
Practice Address - Street 2:SUITE 3K
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-4923
Practice Address - Country:US
Practice Address - Phone:858-866-0340
Practice Address - Fax:858-866-0342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT20075225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA810098482OtherPRIVATE HEALTHCARE SYSTEM
CA361238600OtherAFFILIATED COMP SERVICES
CACA25980605OtherPREFERRED THERAPY PROVDRS
CAZZZ61556ZOtherBLUE SHIELD OF CA
CAW15538Medicare ID - Type Unspecified