1508964685 NPI number — RODNEY K. SHOREY PHYSICAL THERAPY SERVICES, INC.

Table of content: (NPI 1508964685)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508964685 NPI number — RODNEY K. SHOREY PHYSICAL THERAPY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RODNEY K. SHOREY PHYSICAL THERAPY SERVICES, INC.
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:
WOODLAND HILLS PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
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:
1508964685
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22151 CLARENDON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODLAND HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91367-6308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-884-4810
Provider Business Mailing Address Fax Number:
818-884-4802

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22151 CLARENDON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODLAND HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91367-6308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-884-4810
Provider Business Practice Location Address Fax Number:
818-884-4802
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SHOREY
Authorized Official First Name:
RODNEY
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
310-923-5440

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT22464 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251S0007X , with the licence number: PT22462 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251X0800X , with the licence number: PT22462 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com