Healthcare Provider Details

I. General information

NPI: 1578277075
Provider Name (Legal Business Name): BODY IN MOTION MOBILE PHYSICAL THERAPY & WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 04/12/2023
Certification Date: 01/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25182 FAIRGREEN
MISSION VIEJO CA
92692-2882
US

IV. Provider business mailing address

25182 FAIRGREEN
MISSION VIEJO CA
92692-2882
US

V. Phone/Fax

Practice location:
  • Phone: 949-228-2946
  • Fax:
Mailing address:
  • Phone: 949-228-2946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEEMA MAJAJ
Title or Position: PT, DPT
Credential: PT, DPT
Phone: 949-228-2946