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General NPI Number Information
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NPI Number | 1316987274
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Entity Type | Organization
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Legal Business Name | MARTIN ORTHOPEDIC REHABILITATION PHYSICAL THERAPY INC.
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 27126 PASEO ESPADA STE 1621A
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-6703
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Country | US
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Telephone | 949-347-1021
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Fax | 949-347-0981
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Provider Business Mailing Address
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Address Line | 27126 PASEO ESPADA STE 1621A
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-6703
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Country | US
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Telephone | 949-347-1021
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Fax | 949-347-0981
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRADY C. MARTIN
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Credential | P.T.
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Telephone | 949-347-1021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 23377
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License Number State | CA
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