Provider Demographics
NPI:1740471614
Name:ORDORICA, ERIC PAUL (PT)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:PAUL
Last Name:ORDORICA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S SEPULVEDA BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6814
Mailing Address - Country:US
Mailing Address - Phone:310-546-3461
Mailing Address - Fax:
Practice Address - Street 1:400 S SEPULVEDA BLVD
Practice Address - Street 2:STE 105
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6814
Practice Address - Country:US
Practice Address - Phone:310-546-3461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT33797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist