Healthcare Provider Details

I. General information

NPI: 1518946961
Provider Name (Legal Business Name): CHARLOTTE FEICHTMANN PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18700 BEACH BLVD SUITE 120
HUNTINGTON BEACH CA
92648
US

IV. Provider business mailing address

18700 BEACH BLVD SUITE 120
HUNTINGTON BEACH CA
92648
US

V. Phone/Fax

Practice location:
  • Phone: 714-962-6760
  • Fax: 714-962-5961
Mailing address:
  • Phone: 714-962-6760
  • Fax: 714-962-5961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9061
License Number StateCA

VIII. Authorized Official

Name: MRS. CHARLOTTE ANN FEICHTMANN
Title or Position: OWNER PRESIDENT
Credential: PT PCS
Phone: 714-962-6760