Healthcare Provider Details

I. General information

NPI: 1972422038
Provider Name (Legal Business Name): SUNSET BEACH CONCIERGE PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16736 INTREPID LANE
HUNTINGTON BEACH CA
92649
US

IV. Provider business mailing address

16736 INTREPID LN
HUNTINGTON BEACH CA
92649-2827
US

V. Phone/Fax

Practice location:
  • Phone: 714-253-7896
  • Fax:
Mailing address:
  • Phone: 714-253-7896
  • 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: AARON PLATFOOT
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 714-253-7896