Provider Demographics
NPI:1982617569
Name:JOAN SCHMIDT ORTHOPEDIC PHYSICAL THERAPY
Entity Type:Organization
Organization Name:JOAN SCHMIDT ORTHOPEDIC PHYSICAL THERAPY
Other - Org Name:WESTWOOD PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:310-996-0085
Mailing Address - Street 1:11500 W OLYMPIC BLVD # 636
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1524
Mailing Address - Country:US
Mailing Address - Phone:310-996-0085
Mailing Address - Fax:310-996-1064
Practice Address - Street 1:11500 W OLYMPIC BLVD # 636
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1524
Practice Address - Country:US
Practice Address - Phone:310-996-0085
Practice Address - Fax:310-996-1064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW15136Medicare ID - Type Unspecified