Provider Demographics
NPI:1871921080
Name:SAWIRES, GEORGE (DPT, OCS, CKTP)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:SAWIRES
Suffix:
Gender:M
Credentials:DPT, OCS, CKTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21705 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6403
Mailing Address - Country:US
Mailing Address - Phone:424-999-8684
Mailing Address - Fax:424-999-8684
Practice Address - Street 1:21705 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6403
Practice Address - Country:US
Practice Address - Phone:424-999-8684
Practice Address - Fax:424-999-8684
Is Sole Proprietor?:No
Enumeration Date:2013-10-24
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034791-1225100000X
CA40893225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist