| Russell Dial, PT | |
|
1611 W Main St, El Centro, CA 92243-2212 | |
| (760) 337-1144 | |
| (760) 337-8259 |
| Full Name | Russell Dial |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 1611 W Main St, El Centro, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295798676 | NPI | - | NPPES |
| WPT32388C | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT32388 (California) | Primary |
| Provider Name | Eggleton & Langton Physical Therapy Management Services |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1972229805 PECOS PAC ID: 0840192530 Enrollment ID: O20040122001219 |
| Provider Name | Southern California Permanente Medical Group |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
| Mailing Address | Practice Location Address |
|---|---|
| Russell Dial, PT 5905 Severin Dr, La Mesa, CA 91942-3806 Ph: (619) 589-2606 | Russell Dial, PT 1611 W Main St, El Centro, CA 92243-2212 Ph: (760) 337-1144 |
Brandon Morlett, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1611 W Main St, El Centro, CA 92243 Phone: 760-337-1144 | |
Dustin John Andrew Miller, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 426 N Imperial Ave, El Centro, CA 92243 Phone: 760-679-0210 Fax: 760-679-0213 | |
Amisha Kishen Lala, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1611 W Main St, El Centro, CA 92243 Phone: 760-337-1144 Fax: 760-337-8259 | |
Hoang Vu Le, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 426 N Imperial Ave, El Centro, CA 92243 Phone: 760-592-8148 Fax: 760-841-5556 | |
Miss Ann-marie Wurzbach, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 428 N Imperial Ave, El Centro, CA 92243 Phone: 760-353-3422 Fax: 760-353-9163 | |
Viviana Angela Morales, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 426 N Imperial Ave, El Centro, CA 92243 Phone: 760-679-0210 |