Provider Demographics
NPI:1548333586
Name:PREVENT THE PAIN THERAPY, INC.
Entity type:Organization
Organization Name:PREVENT THE PAIN THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:EISENSTADT
Authorized Official - Suffix:
Authorized Official - Credentials:MAPT,OCS
Authorized Official - Phone:310-623-4444
Mailing Address - Street 1:PO BOX 6520
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-6520
Mailing Address - Country:US
Mailing Address - Phone:310-623-4444
Mailing Address - Fax:310-623-4455
Practice Address - Street 1:8818 SATURN ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-3320
Practice Address - Country:US
Practice Address - Phone:310-623-4444
Practice Address - Fax:310-623-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA255062251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty