Provider Demographics
NPI:1639928708
Name:SIERRA THERAPY PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:SIERRA THERAPY PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEFKO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:805-738-5186
Mailing Address - Street 1:3947 VERDE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-2651
Mailing Address - Country:US
Mailing Address - Phone:805-738-5186
Mailing Address - Fax:
Practice Address - Street 1:31293 VIA COLINAS
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3935
Practice Address - Country:US
Practice Address - Phone:805-738-5186
Practice Address - Fax:805-980-4294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty