John Ebster, PHYSICAL THERAPY

Individual provider Active NPI Physical Therapy Assistant · Ripon, CA

NPI 1699148387 · NPPES record last updated Nov 4, 2015

Key facts

NPI
1699148387
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
AT1743 (CA)
Practice address
103 E Main St
Ripon, CA 95366-2416
Phone
(209) 599-7073
Fax
(209) 599-7074
NPI assigned
Nov 4, 2015
Sex
Male
Sole proprietor
No

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
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AT1743CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Xcel Orthopaedic Physical Therapy Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT1743 CA Yes

Addresses

Primary practice location

103 E Main St
Ripon, CA 95366-2416

Mailing address

2406 Fremont Ave
Modesto, CA 95350-2288
Phone (209) 404-6674

Other identifiers

IdentifierTypeStateIssuer
ZZZ18198ZOtherCAPTAN

Other providers in Ripon, CA

All providers in Ripon, CA · Physical Therapy Assistant in California

Sources for this page

Verify at the official NPI Registry.