Healthcare Provider Details

I. General information

NPI: 1508699307
Provider Name (Legal Business Name): AUSTIN R RAPP ATS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 RIMANI DR
MISSION VIEJO CA
92692-5105
US

IV. Provider business mailing address

10 RIMANI DR
MISSION VIEJO CA
92692-5105
US

V. Phone/Fax

Practice location:
  • Phone: 949-426-1512
  • Fax:
Mailing address:
  • Phone: 949-426-1512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number319048
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: