Healthcare Provider Details

I. General information

NPI: 1285529420
Provider Name (Legal Business Name): VITAL PERFORMANCE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3870 EL HIJO ST UNIT B
RIVERSIDE CA
92504-2714
US

IV. Provider business mailing address

3870 EL HIJO ST UNIT B
RIVERSIDE CA
92504-2714
US

V. Phone/Fax

Practice location:
  • Phone: 818-455-1388
  • Fax:
Mailing address:
  • Phone: 818-455-1388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES RECINOS
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 818-455-1388