Healthcare Provider Details

I. General information

NPI: 1801435193
Provider Name (Legal Business Name): CUIRIM SPORTS PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 BAKER ST
COSTA MESA CA
92626-4138
US

IV. Provider business mailing address

1111 BAKER ST
COSTA MESA CA
92626-4138
US

V. Phone/Fax

Practice location:
  • Phone: 443-797-2766
  • Fax:
Mailing address:
  • Phone: 443-797-2766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK LAWRENCE EVERETT
Title or Position: OWNER
Credential: PT, DPT, ATC, MSAT
Phone: 443-797-2766