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General NPI Number Information
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NPI Number | 1386528412
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Entity Type | Organization
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Legal Business Name | PEAK POTENTIAL PHYSICAL THERAPY
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 11 CALLE DE ARENA
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2870
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Country | US
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Telephone | 949-295-9675
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Fax | 949-325-9644
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Provider Business Mailing Address
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Address Line | 11 CALLE DE ARENA
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2870
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Country | US
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Telephone | 949-295-9675
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Fax |
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Authorized Official
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Title or Position | CEO, DOCTOR OF PHYSICAL THERAPY
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Name | DR. LAURETTA MARIE RUSTAD
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Credential | PT, DPT, CCI
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Telephone | 949-295-9675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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