Organization
PREMIER HOME PHYSICAL THERAPY, INC
Active
Organization
PREMIER HOME PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ANTHONY BERKOVICH (PHYSICAL THERAPIST)
(310) 918-0765
Entity
Organization
Contact information
Practice address
1300 W 6TH ST, SUITE 3, SAN PEDRO, CA 90732-3531
(310) 519-1030
(310) 519-0194
Mailing address
3146 CROWNVIEW DR, RANCHO PALOS VERDES, CA 90275-6414
(310) 918-0765
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT26104
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT26104
MEDICARE PTAN
CA
Enumeration date
04/22/2014
Last updated
04/22/2014
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