Healthcare Provider Details

I. General information

NPI: 1457675662
Provider Name (Legal Business Name): PT PLUS REHAB, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2010
Last Update Date: 04/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 CABRILLO PARK DR SUITE 100
SANTA ANA CA
92701-5016
US

IV. Provider business mailing address

24 HAMMOND UNIT C
IRVINE CA
92618-1680
US

V. Phone/Fax

Practice location:
  • Phone: 714-571-0141
  • Fax: 800-924-7223
Mailing address:
  • Phone: 949-770-6022
  • Fax: 949-770-7084

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: ALBERTO A MARCIANO
Title or Position: OWNER
Credential:
Phone: 949-770-6022