Provider Demographics
NPI:1194807941
Name:WEST POINT PHYSICAL THERAPY CENTER, INC
Entity type:Organization
Organization Name:WEST POINT PHYSICAL THERAPY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARZOCCHETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-265-0060
Mailing Address - Street 1:1115 WEST AVE.. M - 14
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1407
Mailing Address - Country:US
Mailing Address - Phone:661-265-0060
Mailing Address - Fax:661-265-0199
Practice Address - Street 1:1115 WEST AVE. M - 14
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1407
Practice Address - Country:US
Practice Address - Phone:661-265-0060
Practice Address - Fax:661-265-0199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW15453Medicare ID - Type UnspecifiedGROUP PROVIDER #
CAZZZ23107ZMedicare ID - Type UnspecifiedGROUP PROVIDER #