Healthcare Provider Details

I. General information

NPI: 1669994992
Provider Name (Legal Business Name): COURY & BUEHLER PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13931 CARROLL WAY STE B
TUSTIN CA
92780-1861
US

IV. Provider business mailing address

3230 E IMPERIAL HWY STE 100
BREA CA
92821-6735
US

V. Phone/Fax

Practice location:
  • Phone: 714-256-5074
  • Fax: 714-256-0770
Mailing address:
  • Phone: 714-988-8113
  • Fax: 714-988-8114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name: RICHARD JUDE COURY
Title or Position: OWNER, CEO, CFO
Credential: PT,MPT,OCS,ATC,CSCS
Phone: 714-256-5074