Provider Demographics
NPI:1376204438
Name:FLINTRIDGE PHYSICAL THERAPY
Entity type:Organization
Organization Name:FLINTRIDGE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:BRANDON
Authorized Official - Last Name:DARBIDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:818-378-1228
Mailing Address - Street 1:2520 HONOLULU AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1853
Mailing Address - Country:US
Mailing Address - Phone:818-378-1228
Mailing Address - Fax:800-418-6870
Practice Address - Street 1:2520 HONOLULU AVE STE 150
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1853
Practice Address - Country:US
Practice Address - Phone:818-378-1228
Practice Address - Fax:800-418-6870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-31
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy