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NPI Code Detail

MEDICARE: ANGELINE MOC P.T.

MEDICARE: ANGELINE MOC P.T.
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 Therapist302641CA

General Provider Information

NPI Number : 1902524374
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELINE MOC P.T.
Provider Business Mailing Address
First Line : 3900 E PACIFIC COAST HWY
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-2000
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3900 E PACIFIC COAST HWY
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-2000
Country : US
Telephone Number : 562-986-2317
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2022
Last Update Date : 03/03/2026

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Directions to “ ANGELINE MOC P.T.” Practice Location

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