Provider Demographics
NPI:1902300080
Name:PAGADOR PHYSICAL THERAPY INCORPORATED
Entity Type:Organization
Organization Name:PAGADOR PHYSICAL THERAPY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:LILYANNE
Authorized Official - Middle Name:P
Authorized Official - Last Name:PAGADOR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:619-296-5780
Mailing Address - Street 1:7801 MISSION CENTER CT STE 430
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1332
Mailing Address - Country:US
Mailing Address - Phone:619-296-5780
Mailing Address - Fax:619-296-5787
Practice Address - Street 1:7801 MISSION CENTER CT STE 430
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1332
Practice Address - Country:US
Practice Address - Phone:619-296-5780
Practice Address - Fax:619-296-5787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT4000002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty