Provider Demographics
NPI:1366511164
Name:BECK AND CALE PHYSICAL THERAPY
Entity type:Organization
Organization Name:BECK AND CALE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:CALE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:805-922-1724
Mailing Address - Street 1:477 PLATINO LN
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-2307
Mailing Address - Country:US
Mailing Address - Phone:805-474-9209
Mailing Address - Fax:
Practice Address - Street 1:150 MARY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:NIPOMO
Practice Address - State:CA
Practice Address - Zip Code:93444-7820
Practice Address - Country:US
Practice Address - Phone:805-929-3230
Practice Address - Fax:805-929-3232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT13403261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW15004AMedicare ID - Type Unspecified