Healthcare Provider Details

I. General information

NPI: 1033266275
Provider Name (Legal Business Name): BROWN PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5851 LANCEFIELD DR
HUNTINGTON BEACH CA
92649-4904
US

IV. Provider business mailing address

13071 BROOKHURST ST STE 110
GARDEN GROVE CA
92843-1047
US

V. Phone/Fax

Practice location:
  • Phone: 760-218-1400
  • Fax: 714-840-3694
Mailing address:
  • Phone: 714-636-7410
  • Fax: 714-636-6874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT5873
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateCO

VIII. Authorized Official

Name: JAMES BROWN
Title or Position: OWNER
Credential: PT
Phone: 760-218-1400