Healthcare Provider Details

I. General information

NPI: 1508936626
Provider Name (Legal Business Name): COMPLETE BALANCE SOLUTION INSTITUTE OF PHYSIOTHERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24422 AVENIDA DE LA CARLOTA SUITE 190
LAGUNA HILLS CA
92653-7602
US

IV. Provider business mailing address

24422 AVENIDA DE LA CARLOTA SUITE 190
LAGUNA HILLS CA
92653-7602
US

V. Phone/Fax

Practice location:
  • Phone: 949-340-6927
  • Fax: 949-215-7246
Mailing address:
  • Phone: 949-340-6927
  • Fax: 949-215-7246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT27537
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT27537
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT26543
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT26543
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT27537
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT26543
License Number StateCA

VIII. Authorized Official

Name: SAPAN NARESH PALKHIWALA
Title or Position: PRESIDENT/OWNER/DIRECTOR
Credential: D.P.T.
Phone: 949-340-6927