1205931482 NPI number — ADVANCED ORTHOPEDIC PHYSICAL THERAPY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205931482 NPI number — ADVANCED ORTHOPEDIC PHYSICAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED ORTHOPEDIC PHYSICAL THERAPY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205931482
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2501 CHERRY AVE
Provider Second Line Business Mailing Address:
SUITE 250
Provider Business Mailing Address City Name:
SIGNAL HILL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90755-2031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-595-5159
Provider Business Mailing Address Fax Number:
562-595-7839

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2501 CHERRY AVE STE 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIGNAL HILL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90755-2041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-595-5159
Provider Business Practice Location Address Fax Number:
562-595-7839
Provider Enumeration Date:
09/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SOGAARD
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
562-595-5159

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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