Healthcare Provider Details

I. General information

NPI: 1710584768
Provider Name (Legal Business Name): SARAH REICHEL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 MARTIN LUTHER KING JR BLVD STE 500
LYNWOOD CA
90262-3533
US

IV. Provider business mailing address

12501 SEAL BEACH BLVD STE 210
SEAL BEACH CA
90740-2755
US

V. Phone/Fax

Practice location:
  • Phone: 562-333-3700
  • Fax:
Mailing address:
  • Phone: 562-493-8800
  • Fax: 562-493-2980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT298807
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT298807
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: