1144677212 NPI number — PAINFREE PHYSICAL THERAPY CORP A PROFESSIONAL CORPORATION

Table of content: (NPI 1144677212)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144677212 NPI number — PAINFREE PHYSICAL THERAPY CORP A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAINFREE PHYSICAL THERAPY CORP A PROFESSIONAL CORPORATION
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:
1144677212
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5451 LA PALMA AVE STE 48
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA PALMA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90623-1732
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-362-9353
Provider Business Mailing Address Fax Number:
562-278-0199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5451 LA PALMA AVE STE 48
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA PALMA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90623-1732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-362-9353
Provider Business Practice Location Address Fax Number:
562-278-0199
Provider Enumeration Date:
05/19/2016

Additional Information

Authorized Official

Authorized Official Last Name:
CHAO
Authorized Official First Name:
WAN-KAI
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
562-362-9353

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT37756 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: PT37756 . This is a "PHYSICAL THERAPY BOARD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com