Healthcare Provider Details

I. General information

NPI: 1023757374
Provider Name (Legal Business Name): HOMELINK PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23665 GOLDEN SPRINGS DR UNIT 2E
DIAMOND BAR CA
91765-2192
US

IV. Provider business mailing address

23665 GOLDEN SPRINGS DR UNIT 2E
DIAMOND BAR CA
91765-2192
US

V. Phone/Fax

Practice location:
  • Phone: 714-812-4795
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: REGIELOUR HOLGADO
Title or Position: PRESIDENT
Credential: PT, DPT, CAPS
Phone: 714-362-5100