Premier Home Physical Therapy, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT26104 Issued in CA

Legal business name

PREMIER HOME PHYSICAL THERAPY, INC

Practice address

1300 W 6TH St
Suite 3
San Pedro, CA 90732-3531

Phone

(310) 519-1030

Fax

(310) 519-0194

NPI assigned

Apr 22, 2014

Last updated

Apr 22, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John Anthony BerkovichNPI 1407073133

Title

Physical Therapist

Phone

(310) 918-0765

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Anthony Berkovich Sr., PT

  • Physical Therapist
  • Rancho Palos Verdes, CA
  • NPI 1407073133
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398124800000",
    "number": "1316367915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3146 CROWNVIEW DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902756414",
            "telephone_number": "310-918-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W 6TH ST",
            "address_2": "SUITE 3",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323531",
            "telephone_number": "310-519-1030",
            "fax_number": "310-519-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HOME PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-22",
        "last_updated": "2014-04-22",
        "status": "A",
        "authorized_official_last_name": "BERKOVICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "310-918-0765",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT26104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "PT26104",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Port Medical San Pedro
• Pourteymoor Acupuncture, a Professional Corporation
• Pourteymoor Chiropractic, a Professional Corporation
• Kombiz Pouteymoor, D.C.
• Praxis Physical Therapy, Inc.
• Premier Physical Therapy and Wellness Clinic Inc.
• Premier Weight Loss Medical Clinic
• Anya Price, RN
• Procare Health Clinic
• Professional Anesthesia Associates PC

• Physical Therapy Clinic/Center in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.