Provider Demographics
NPI:1528176419
Name:PERFORMANCE PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:PERFORMANCE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:LINGAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, OCS, SCS
Authorized Official - Phone:909-796-7700
Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-0261
Mailing Address - Country:US
Mailing Address - Phone:909-796-7700
Mailing Address - Fax:909-796-4384
Practice Address - Street 1:25864 BUSINESS CENTER DR STE C
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4515
Practice Address - Country:US
Practice Address - Phone:909-796-7700
Practice Address - Fax:909-796-4384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT184841OtherMEDICARE ID
CAOPT74550OtherMEDICARE ID
CAOPT106731OtherMEDICARE ID
CAOPT74550OtherMEDICARE ID