Provider Demographics
NPI:1366788945
Name:OCEAN VIEW PHYSICAL THERAPY
Entity type:Organization
Organization Name:OCEAN VIEW PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:TENDRIH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:917-779-0571
Mailing Address - Street 1:194 RUTH ANN WAY
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-2459
Mailing Address - Country:US
Mailing Address - Phone:917-779-0571
Mailing Address - Fax:
Practice Address - Street 1:194 RUTH ANN WAY
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-2459
Practice Address - Country:US
Practice Address - Phone:917-779-0571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-30
Last Update Date:2012-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty