Provider Demographics
NPI:1861402950
Name:ADORADOR ENTERPRISES INC
Entity type:Organization
Organization Name:ADORADOR ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:P.T.
Authorized Official - Prefix:MR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:ADORADOR
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:951-769-0300
Mailing Address - Street 1:1676 EAST 6TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-2550
Mailing Address - Country:US
Mailing Address - Phone:951-769-0300
Mailing Address - Fax:951-769-2811
Practice Address - Street 1:1676 EAST 6TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-2550
Practice Address - Country:US
Practice Address - Phone:951-769-0300
Practice Address - Fax:951-769-2811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24475261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy