Healthcare Provider Details

I. General information

NPI: 1871415604
Provider Name (Legal Business Name): LVL UP PHYSICAL THERAPY & PERFORMANCE, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1274 S MACDUFF ST
ANAHEIM CA
92804-8057
US

IV. Provider business mailing address

1274 S MACDUFF ST
ANAHEIM CA
92804-8057
US

V. Phone/Fax

Practice location:
  • Phone: 562-618-2227
  • Fax:
Mailing address:
  • Phone: 562-618-2227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ISAYA MICHAEL REYES
Title or Position: PRESIDENT
Credential: DPT
Phone: 562-618-2227