Provider Demographics
NPI:1063933117
Name:HANSON & ASSOCIATES PHYSICAL THERAPY
Entity type:Organization
Organization Name:HANSON & ASSOCIATES PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATHU
Authorized Official - Middle Name:NATAKI
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, MBA
Authorized Official - Phone:951-479-2139
Mailing Address - Street 1:11762 DE PALMA RD STE 1C-492
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-4010
Mailing Address - Country:US
Mailing Address - Phone:951-479-2139
Mailing Address - Fax:951-254-9928
Practice Address - Street 1:4300 GREEN RIVER RD STE 114
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880
Practice Address - Country:US
Practice Address - Phone:951-382-4238
Practice Address - Fax:951-254-9928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty