Healthcare Provider Details

I. General information

NPI: 1568917599
Provider Name (Legal Business Name): ART OF REHAB PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 08/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26446 FRESNO DR
MISSION VIEJO CA
92691-1513
US

IV. Provider business mailing address

460 OLD NEWPORT BLVD
NEWPORT BEACH CA
92663-4211
US

V. Phone/Fax

Practice location:
  • Phone: 949-689-9004
  • Fax:
Mailing address:
  • Phone: 949-689-9004
  • Fax: 949-258-5787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number38468
License Number StateCA

VIII. Authorized Official

Name: PARTH PATEL
Title or Position: PRESIDENT/PROVIDER
Credential: DPT
Phone: 949-689-9004