Provider Demographics
NPI:1720092646
Name:COX PHYSICAL THERAPY INC A
Entity Type:Organization
Organization Name:COX PHYSICAL THERAPY INC A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARLEEN
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:818-237-5759
Mailing Address - Street 1:3808 W RIVERSIDE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4325
Mailing Address - Country:US
Mailing Address - Phone:818-237-5759
Mailing Address - Fax:818-237-5509
Practice Address - Street 1:3808 W RIVERSIDE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4325
Practice Address - Country:US
Practice Address - Phone:818-237-5759
Practice Address - Fax:818-237-5509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27393225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19597Medicare ID - Type UnspecifiedMEDICARE GROUP