Healthcare Provider Details

I. General information

NPI: 1487308656
Provider Name (Legal Business Name): BELL PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2022
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5972 EDMONDS CIR
HUNTINGTON BEACH CA
92649-3704
US

IV. Provider business mailing address

5972 EDMONDS CIR
HUNTINGTON BEACH CA
92649-3704
US

V. Phone/Fax

Practice location:
  • Phone: 657-329-9781
  • Fax:
Mailing address:
  • Phone: 657-329-9781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMUEL BELL III
Title or Position: OWNER
Credential: DPT, PT, MS, ATC
Phone: 657-204-6069