Provider Demographics
NPI:1639302136
Name:EXECUTIVE HAND THERAPY, INC.
Entity type:Organization
Organization Name:EXECUTIVE HAND THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:YARON
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-564-8210
Mailing Address - Street 1:400 N TUSTIN AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3813
Mailing Address - Country:US
Mailing Address - Phone:714-564-8210
Mailing Address - Fax:714-564-8306
Practice Address - Street 1:400 N TUSTIN AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3813
Practice Address - Country:US
Practice Address - Phone:714-564-8210
Practice Address - Fax:714-564-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy