Provider Demographics
NPI:1144483595
Name:TEMECULA VALLEY PHYSICAL THERAPY
Entity type:Organization
Organization Name:TEMECULA VALLEY PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HUNTINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:951-600-8024
Mailing Address - Street 1:41555 CHERRY ST
Mailing Address - Street 2:STE L
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6402
Mailing Address - Country:US
Mailing Address - Phone:951-600-8024
Mailing Address - Fax:951-600-8524
Practice Address - Street 1:41555 CHERRY ST
Practice Address - Street 2:STE L
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6402
Practice Address - Country:US
Practice Address - Phone:951-600-8024
Practice Address - Fax:951-600-8524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT2799602251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT279960OtherBLUE SHIELD PIN
CAOPT279960OtherBLUE SHIELD PIN