1952610438 NPI number — LITTLEFIELD PHYSICAL THERAPY, INC.

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 1952610438 NPI number — LITTLEFIELD PHYSICAL THERAPY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LITTLEFIELD 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:
1952610438
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 893337
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TEMECULA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92589-3337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-676-7693
Provider Business Mailing Address Fax Number:
951-676-7830

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1445 N SUNRISE WAY
Provider Second Line Business Practice Location Address:
STE. 102A
Provider Business Practice Location Address City Name:
PALM SPRINGS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92262-3700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-322-1014
Provider Business Practice Location Address Fax Number:
760-322-1074
Provider Enumeration Date:
09/30/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LITTLEFIELD
Authorized Official First Name:
PETER
Authorized Official Middle Name:
MARTIN
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
951-676-7693

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  28443 , 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: 0833139 . This is a "MEDI-CAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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