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Organization
GENESIS PHYSICAL THERAPY INC.
Active
Organization
GENESIS PHYSICAL THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PILAR MARIE HANES MPT (OWNER)
(805) 583-9575
Entity
Organization
Contact information
Practice address
2807 E. COCHRAN STREET, SIMI VALLEY, CA 93065-1207
(805) 583-9575
Mailing address
PO BOX 1448, SIMI VALLEY, CA 93062-1448
(805) 583-9575
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT26886
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
607330100
DEPT OF LABOR
CA
01
—
ZZZ65708Z
BLUE SHIELD
CA
Enumeration date
07/30/2006
Last updated
12/20/2018
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