1558498337 NPI number — WESTLAKE PHYSICAL THERAPY, INC.

Table of content: (NPI 1558498337)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558498337 NPI number — WESTLAKE PHYSICAL THERAPY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTLAKE PHYSICAL THERAPY, 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:
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:
1558498337
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/06/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1220 LA VENTA DR
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
WESTLAKE VILLAGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91361-3703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-777-7370
Provider Business Mailing Address Fax Number:
805-777-7380

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 JENSEN CT
Provider Second Line Business Practice Location Address:
SUITE 2C
Provider Business Practice Location Address City Name:
THOUSAND OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91360-7483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-413-1070
Provider Business Practice Location Address Fax Number:
805-413-1076
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VASQUEZ
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
CARMEN
Authorized Official Title or Position:
P.T., OWNER, SECRETARY & TREASURER
Authorized Official Telephone Number:
805-777-7370

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1043236078 . This is a "PRIMARY GROUP NPI #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com