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NPI Code Detail

MEDICARE: MANHATTAN BEACH PACIFIC PHYSICAL THERAPY INC

MEDICARE: MANHATTAN BEACH PACIFIC PHYSICAL THERAPY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistCA

General Provider Information

NPI Number : 1396799458
Entity Type Code : Organization
Provider Name (Legal Business Name) : MANHATTAN BEACH PACIFIC PHYSICAL THERAPY INC
Provider Business Mailing Address
First Line : 327 MAIN ST
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-3814
Country : US
Telephone Number : 310-725-8505
Fax Number : 310-648-3175
Provider Business Practice Location Address
First Line : 327 MAIN ST
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-3814
Country : US
Telephone Number : 310-725-8505
Fax Number : 310-648-3175
Authorized Official
Title or Position : CEO
Name : MR. CHRISTOPHER P DEROSA
Credential : PT
Telephone Number : 310-648-3167
Provider Enumeration Date : 05/20/2006
Last Update Date : 06/10/2019

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Directions to “MANHATTAN BEACH PACIFIC PHYSICAL THERAPY INC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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