Healthcare Provider Details

I. General information

NPI: 1225614332
Provider Name (Legal Business Name): COURY & BUEHLER PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 ICON
LAKE FOREST CA
92610-3000
US

IV. Provider business mailing address

3230 E IMPERIAL HWY STE 100
BREA CA
92821-6735
US

V. Phone/Fax

Practice location:
  • Phone: 949-954-0090
  • Fax: 949-988-0287
Mailing address:
  • Phone: 714-988-8113
  • Fax: 714-988-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LETITIA MAE SAMONTE
Title or Position: VP OF FINANCE
Credential:
Phone: 714-988-8113