Provider Demographics
NPI:1124098058
Name:FUNCTION&ACTION PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:FUNCTION&ACTION PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOSHIKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-299-0344
Mailing Address - Street 1:255 W BULLARD AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-0861
Mailing Address - Country:US
Mailing Address - Phone:559-299-0344
Mailing Address - Fax:559-299-0391
Practice Address - Street 1:255 W BULLARD AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-0861
Practice Address - Country:US
Practice Address - Phone:559-299-0344
Practice Address - Fax:559-299-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA610748800OtherOWCP GROUP ID NUMBER
CAZZZ64289ZOtherBLUE SHIELD GROUP ID #