Healthcare Provider Details

I. General information

NPI: 1013824036
Provider Name (Legal Business Name): TIMOTHY RITHY MANN PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17872 GILLETTE AVE STE 210
IRVINE CA
92614-6573
US

IV. Provider business mailing address

5152 OCASO AVE
BUENA PARK CA
90621-1220
US

V. Phone/Fax

Practice location:
  • Phone: 949-777-5301
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310750
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: