Healthcare Provider Details

I. General information

NPI: 1184984387
Provider Name (Legal Business Name): LA PAZ SPINE AND REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 10/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25200 LA PAZ RD STE 102
LAGUNA HILLS CA
92653-5134
US

IV. Provider business mailing address

25200 LA PAZ RD STE 102
LAGUNA HILLS CA
92653-5134
US

V. Phone/Fax

Practice location:
  • Phone: 949-770-8767
  • Fax:
Mailing address:
  • Phone: 949-770-8767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH PREZIOSI
Title or Position: OWNER
Credential: DC
Phone: 949-770-8767