Healthcare Provider Details

I. General information

NPI: 1588985832
Provider Name (Legal Business Name): PREMIER PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26730 TOWNE CENTRE DR STE 204
FOOTHILL RANCH CA
92610-2842
US

IV. Provider business mailing address

26730 TOWNE CENTRE DR STE 204
FOOTHILL RANCH CA
92610-2842
US

V. Phone/Fax

Practice location:
  • Phone: 949-716-5050
  • Fax: 949-482-2122
Mailing address:
  • Phone: 949-716-5050
  • Fax: 949-482-2122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CARY COSTA
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: DPT
Phone: 949-716-5050