Provider Demographics
NPI:1386620250
Name:GEORGE ERB PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:GEORGE ERB PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ERB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-484-2026
Mailing Address - Street 1:231 CAMARILLO RANCH RD
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5082
Mailing Address - Country:US
Mailing Address - Phone:805-484-2026
Mailing Address - Fax:805-389-1196
Practice Address - Street 1:231 CAMARILLO RANCH RD
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5082
Practice Address - Country:US
Practice Address - Phone:805-484-2026
Practice Address - Fax:805-389-1196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2019-08-27
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
CA056683Medicare ID - Type Unspecified