| Organization Name: | BERETTA PHYSICAL THERAPY, INC. |
| NPI Number: | 1093954943 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL J. BERETTA (PRESIDENT) |
| Mailing Address: | 5145 Golden Foothill Pkwy Ste 190 El Dorado Hills |
| State: | CA US |
| Postal Code: | 957629655 |
| Phone Number: | 9169412440 |
| Fax Number: | 9169412450 |
| NPI Enumeration Date: | 02/17/2009 |
| NPI Last Update Date: | 02/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | PT26962 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |