Provider Demographics
NPI:1437169059
Name:ALAMITOS PHYSICAL THERAPY
Entity type:Organization
Organization Name:ALAMITOS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:SIDNEY
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT OCS
Authorized Official - Phone:562-795-5295
Mailing Address - Street 1:10682 LOS ALAMITOS BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2118
Mailing Address - Country:US
Mailing Address - Phone:562-795-5295
Mailing Address - Fax:562-795-5297
Practice Address - Street 1:10682 LOS ALAMITOS BLVD
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720
Practice Address - Country:US
Practice Address - Phone:562-795-5295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-07-22
Deactivation Date:2007-09-19
Deactivation Code:
Reactivation Date:2020-07-22
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty