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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 (PROVIDER RELATIONS SUPERVISOR)
(951) 696-9353
Entity
Organization
Contact information
Practice address
31720 TEMECULA PKWY, STE 101, TEMECULA, CA 92592-5802
(951) 303-3566
(951) 303-3577
Mailing address
600 CENTRAL AVE STE C, LAKE ELSINORE, CA 92530-2740
(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
—
1679541320
—
CA
01
—
ZZZ00453Z
BLUE SHIELD
CA
Enumeration date
03/09/2006
Last updated
03/14/2022
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