| NPI | 1184734931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY J RIVELLO Office/Billing Manager 949-465-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT24606) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT24624) |
| 225100000X Physical Therapist (Licence: CA PT29999) | |
| 225100000X Physical Therapist (Licence: CA PT30004) | |
| 225X00000X Occupational Therapist (Licence: CA OT142) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-06-05 |