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General NPI Number Information
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NPI Number | 1265673842
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Entity Type | Organization
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Legal Business Name | HEALTH QUEST PHYSICAL THERAPY GROUP INC
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 26941 CABOT RD 103
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7030
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Country | US
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Telephone | 888-564-2081
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1132
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City | LAKE FOREST
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State | CA
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Zip | 92609-1132
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Country | US
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Telephone | 888-564-2081
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Fax | 949-916-1403
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Authorized Official
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Title or Position | OWNER
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Name | MR. PAUL ROBERT ADDISON JR.
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Credential | MPT
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Telephone | 714-625-7989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 34602
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 34602
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License Number State | CA
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