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General NPI Number Information
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NPI Number | 1104017730
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC AND SPINE CARE PHYSICAL THERAPY A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 04/01/2014
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Provider Practice Location Address
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Address Line | 6082 EDINGER AVE SUITE 100
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3264
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Country | US
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Telephone | 714-840-1505
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Fax | 714-840-2504
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Provider Business Mailing Address
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Address Line | 6082 EDINGER AVE SUITE 100
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3264
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Country | US
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Telephone | 714-840-1505
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Fax | 714-840-2504
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Authorized Official
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Title or Position | OWNER
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Name | MS. CINDY SHAW
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Credential |
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Telephone | 714-840-1505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT10271
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License Number State | CA
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