Healthcare Provider Details

I. General information

NPI: 1588472948
Provider Name (Legal Business Name): LUITHLY PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 W MACARTHUR BLVD STE 908
SANTA ANA CA
92704-6842
US

IV. Provider business mailing address

430 ENCLAVE CIR APT 303
COSTA MESA CA
92626-8297
US

V. Phone/Fax

Practice location:
  • Phone: 714-386-9544
  • Fax: 714-556-4334
Mailing address:
  • Phone: 949-981-2687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRYAN JAMES LUITHLY
Title or Position: OWNER/ PHYSICAL THERAPIST
Credential: DPT, PT, OCS, CSCS
Phone: 949-981-2687