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Organization
RANCHO PHYSICAL THERAPY, INC.
Active
Organization
RANCHO PHYSICAL THERAPY, INC.
Active
Other names
Rancho Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELA LITT (CREDENTIALING COORDINATOR)
(951) 696-9353
Entity
Organization
Contact information
Practice address
24021 ALESSANDRO BLVD STE 109, MORENO VALLEY, CA 92553-6709
(951) 485-4594
(951) 485-9560
Mailing address
30428 HAUN RD STE 810, MENIFEE, CA 92584-6824
(951) 696-9353
(951) 973-7216
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285602946
—
CA
01
—
ZZZ05525Z
BLUE SHIELD - OT
CA
01
—
ZZZ36686Z
BLUE SHIELD - PT
CA
Enumeration date
03/09/2006
Last updated
07/14/2025
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