Healthcare Provider Details

I. General information

NPI: 1174848055
Provider Name (Legal Business Name): OC PHYSICAL THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2010
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 COPORATE PARK 145
IRVINE CA
92606
US

IV. Provider business mailing address

18102 SKY PARK CIR #C
IRVINE CA
92614-6531
US

V. Phone/Fax

Practice location:
  • Phone: 949-333-2224
  • Fax: 949-333-2225
Mailing address:
  • Phone: 949-502-3300
  • Fax: 949-333-2225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHIAO-LAN LI
Title or Position: PHYSICAL THERAPIST / OWNER
Credential: MPT
Phone: 949-333-2224