Healthcare Provider Details

I. General information

NPI: 1376206391
Provider Name (Legal Business Name): MOVEWELL PHYSICAL THERAPY OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2021
Last Update Date: 10/17/2021
Certification Date: 10/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13241 HART PL
CERRITOS CA
90703-1334
US

IV. Provider business mailing address

13241 HART PL
CERRITOS CA
90703-1334
US

V. Phone/Fax

Practice location:
  • Phone: 562-331-8404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS OIFOH
Title or Position: OWNER
Credential:
Phone: 562-331-8404