ANOCHA SUPHOL MPT NPI 1003031899

Physical Therapist (Sports) in Riverside, CA

NPI 1003031899 Individual Male Physical Therapist Sports

About ANOCHA SUPHOL

Anocha Suphol is a provider established in Riverside, California and his medical specialization is physical therapist (sports) . The NPI number of Anocha Suphol is 1003031899 and was assigned on April 2007. The practitioner's primary taxonomy code is 2251S0007X with license number PT27871 (CA). The provider is registered as an individual and his NPI record was last updated 15 years ago.

Anocha Suphol is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1003031899

Provider Name ANOCHA SUPHOL MPT
Provider Location Address4444 MAGNOLIA AVE RIVERSIDE, CA 92501
Provider Mailing Address4444 MAGNOLIA AVE RIVERSIDE, CA 92501
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date04-16-2007
Last Update Date07-08-2007


Primary Taxonomy

Taxonomy Code2251S0007X
ClassificationPhysical Therapist
TypeRespiratory, Developmental, Rehabilitative and Restorative Service Providers
SpecializationSports
License No.PT27871
License StateCA
Taxonomy DescriptionA licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, pathology and pathophysiology, medical and surgical intervention, and health and wellness, as well as rehabilitation/return to sports, management of acute injury/illness, medical and surgical consideration, injury prevention, and sports performance enhancement.

Business Address

ANOCHA SUPHOL MPT
4444 MAGNOLIA AVE
RIVERSIDE, CA
ZIP 92501
Phone: (951) 274-3524
Fax: (951) 274-3442

Get Directions


Mailing Address

ANOCHA SUPHOL MPT
4444 MAGNOLIA AVE
RIVERSIDE, CA
ZIP 92501
Phone: (951) 274-3524
Fax: (951) 274-3442



Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
12251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicPT27871CAN/A

Taxonomy Description: a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.

Other Providers at the same location


The following 13 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1831177567DE ANZA SURGERY CENTER
Organization
Clinic/Center (Ambulatory Surgical)4444 MAGNOLIA AVE SUITE C
RIVERSIDE, CA 92501
(951) 320-7799
1902024169 BRENT HARPER DPT, OCS, CSCS
Individual
Physical Therapist (Sports)4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(951) 682-5661
1932389673DR. CHRISTY JO HORN D.P.T.
Individual
Physical Therapist4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(951) 274-3461
1710131750 DANICA C MACIAS DPT
Individual
Physical Medicine & Rehabilitation4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(951) 682-5661
1295175479MR. JAMES DAVID WINN ATC
Individual
Physical Therapy Assistant4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(909) 319-6406
1275508400MS. JAMES BAUMAN CLOVER JR. MED, ATC, PTA
Individual
Specialist/Technologist (Athletic Trainer)4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(951) 274-3484
1275608937COMMUNITY MEDICAL GROUP OF RIVERSIDE INC
Organization
Orthopaedic Surgery4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(951) 682-5661
1164407391MR. THOMAS MARK HARTLEY M.D.
Individual
Orthopaedic Surgery4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(951) 682-5661
1629293428 MARGERY SANCHEZ OT, CHT
Individual
Occupational Therapist (Hand)4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(951) 274-3524
1013952001 BRIAN D HILD MD
Individual
Orthopaedic Surgery4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(951) 682-5661
1245455104 THEODORA WINN PT
Individual
Physical Therapist (Orthopedic)4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(951) 274-3524
1639394414 KIM SAMOSKY MPT, OCS, ATC
Individual
Physical Therapist (Sports)4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(951) 274-3524
1942497193DR. THOMAS TUAN PHAM D.O., CAQSM
Individual
Family Medicine (Sports Medicine)4444 MAGNOLIA AVE
RIVERSIDE, CA 92501
(949) 929-9519

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.