Provider Demographics
NPI:1134153323
Name:EVERYONE HAS POTENTIAL, INC.
Entity type:Organization
Organization Name:EVERYONE HAS POTENTIAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:SALVAGGIO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PT, OCS
Authorized Official - Phone:949-495-0772
Mailing Address - Street 1:PO BOX 7241
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92607-7241
Mailing Address - Country:US
Mailing Address - Phone:949-495-0772
Mailing Address - Fax:949-495-0772
Practice Address - Street 1:25312 VIA PIEDRA ROJA
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1824
Practice Address - Country:US
Practice Address - Phone:949-495-0772
Practice Address - Fax:949-495-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT240252251G0304X
CAOT5614225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16478Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION