Valley Physical Therapy

Key facts

NPI

1982912267

Entity type

Organization (NPI type 2)

Primary specialty

Specialist 174400000X

License

PT 21672 (CA)

Legal business name

VALLEY PHYSICAL THERAPY

Practice address

688 N Arrowhead Ave Ste 101B
San Bernardino, CA 92401-1144

Phone

(909) 885-7200

Fax

(909) 885-7272

NPI assigned

Sep 20, 2010

Organization subpart

No

Authorized official

Name

Mr. Leonardo Carlito, MPT

Title

Owner

Phone

(909) 885-7200

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 20, 2010.

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1982912267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 N ARROWHEAD AVE STE 101B",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011144",
            "telephone_number": "909-885-7200",
            "fax_number": "909-885-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 N ARROWHEAD AVE STE 101B",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011144",
            "telephone_number": "909-885-7200",
            "fax_number": "909-885-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-20",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "CARLITO",
        "authorized_official_first_name": "LEONARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-885-7200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT 21672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
            "identifier": "PT 21672",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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