Eliza M Zamora-Rada, P.T.

Individual provider Active NPI Physical Therapist · Calimesa, CA

NPI 1295801314 · NPPES record last updated Feb 7, 2024

Key facts

NPI
1295801314
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT26379 (CA)
Practice address
1239 Riviera Dr
Calimesa, CA 92320-1092
Phone
(909) 996-3472
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20060208000311 CA Practitioner - Physical Therapist in Private Practice 3577578814 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT26379 CA Yes

Addresses

Primary practice location

1239 Riviera Dr
Calimesa, CA 92320-1092

Mailing address

1239 Riviera Dr
Calimesa, CA 92320-1092
Phone (909) 996-3472

Other practice location 1

11062 Boren Ave
Loma Linda, CA 92354-6516
Phone (909) 653-4456

Other providers in Calimesa, CA

All providers in Calimesa, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.