Provider Demographics
NPI:1154591691
Name:PHYSICAL THERAPY PROFESSIONALS
Entity type:Organization
Organization Name:PHYSICAL THERAPY PROFESSIONALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:951-302-5213
Mailing Address - Street 1:31309 TEMECULA PKWY
Mailing Address - Street 2:STE. 101
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-6826
Mailing Address - Country:US
Mailing Address - Phone:951-302-5213
Mailing Address - Fax:951-302-5214
Practice Address - Street 1:31309 TEMECULA PKWY
Practice Address - Street 2:STE. 101
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-6826
Practice Address - Country:US
Practice Address - Phone:951-302-5213
Practice Address - Fax:951-302-5214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA054559Medicare Oscar/Certification