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General NPI Number Information
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NPI Number | 1447068036
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Entity Type | Organization
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Legal Business Name | KOAH HEALTH PHYSICAL THERAPY & FUNCTIONAL MEDICINE PC
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Dates
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Enumeration Date | 12/28/2024
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 419 MAIN ST STE B
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-8124
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Country | US
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Telephone | 657-837-0335
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Fax |
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Provider Business Mailing Address
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Address Line | 218 FRANKFORT AVE
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-4928
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Country | US
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Telephone | 323-232-9680
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR OF PHYSICAL THERAPY
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Name | MELANIE CHERNEY
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Credential | PT
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Telephone | 323-232-9680
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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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