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General NPI Number Information
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NPI Number | 1265291124
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Entity Type | Organization
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Legal Business Name | ASCEND LAGUNA WOODS PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 03/14/2024
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 24361 EL TORO RD STE 140
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-8898
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Country | US
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Telephone | 949-694-9988
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Fax | 949-694-9977
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Provider Business Mailing Address
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Address Line | 24361 EL TORO RD STE 140
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-8898
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Country | US
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Telephone | 949-694-9988
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Fax | 949-694-9977
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Authorized Official
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Title or Position | CEO
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Name | DR. JOSEPH PARK
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Credential | DPT
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Telephone | 949-694-9988
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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 |
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License Number State |
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