MEDICARE: PROSPORT PHYSICAL THERAPY PROFESSIONALS 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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1487648341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROSPORT PHYSICAL THERAPY PROFESSIONALS INC

Provider Business Mailing Address
First Line	:	PO BOX 14155
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92863-1555
Country	:	US
Telephone Number	:	714-450-4999
Fax Number	:	714-974-0055

Provider Business Practice Location Address
First Line	:	28924 S WESTERN AVE
Second Line	:	SUITE 101
City	:	RANCHO PALOS VERDES
State	:	CA
Zip	:	90275-0885
Country	:	US
Telephone Number	:	310-548-0104
Fax Number	:	310-548-0559

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BOBBY ISMAIL
Credential	:
Telephone Number	:	209-353-1988

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	12/06/2023

Similar Medicare Providers

1710077227 — MISS REBECA LYN GARVIN P.T.
Practice Location Address:

28924 S WESTERN AVE , SUITE 101
RANCHO PALOS VERDES, CA
90275-0885

Practice Phone: 310-548-0104
Practice Fax:

1356411904 — MAJID MOLAIE M.D.
Practice Location Address:

28924 S. WESTERN AVE. , #201
RANCHO PALOS VERDES, CA
90275-0885

Practice Phone: 310-514-8034
Practice Fax: 310-833-3508

1245385509 — MR. DON K ROSAS P.T.
Practice Location Address:

28924 S WESTERN AVE , STE 101
RANCHO PALOS VERDES, CA
90275-0885

Practice Phone: 310-548-0104
Practice Fax: 310-548-0559

1124159413 — DR. AMY L KENNEDY D.C.
Practice Location Address:

28924 S WESTERN AVE , SUITE 208
RANCHO PALOS VERDES, CA
90275-0885

Practice Phone: 310-831-8833
Practice Fax: 310-831-8831

1952422016 — DR. DAVID CHI D. C.
Practice Location Address:

28924 S. WESTERN AVE. , SUITE 208
RANCHO PALOS VERDES, CA
90275-0885

Practice Phone: 310-831-8833
Practice Fax: 310-831-8831

1417244922 — MISS KATRINA LYNN ZAPPALA DPT
Practice Location Address:

28924 S WESTERN AVE , SUITE 101
RANCHO PALOS VERDES, CA
90275-0885

Practice Phone: 310-548-0104
Practice Fax: 310-548-0559

Directions to “PROSPORT PHYSICAL THERAPY PROFESSIONALS INC ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.