Provider Demographics
NPI:1053704098
Name:ALPHA PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:ALPHA PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:MASIH
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:909-252-6334
Mailing Address - Street 1:25612 BARTON RD # 362
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3110
Mailing Address - Country:US
Mailing Address - Phone:909-771-4355
Mailing Address - Fax:
Practice Address - Street 1:11374 MOUNTAIN VIEW AVE # A1
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3830
Practice Address - Country:US
Practice Address - Phone:909-771-4355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy