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General NPI Number Information
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NPI Number | 1447079785
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Entity Type | Organization
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Legal Business Name | CORE ELEMENT PHYSICAL THERAPY AND WELLNESS PC
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Dates
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Enumeration Date | 10/04/2024
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Last Update Date | 12/21/2024
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Provider Practice Location Address
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Address Line | 375 CARMEN DR
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City | CAMARILLO
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State | CA
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Zip | 93010-6033
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Country | US
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Telephone | 818-261-0567
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Fax |
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Provider Business Mailing Address
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Address Line | 5062 CREEKSIDE RD
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City | CAMARILLO
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State | CA
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Zip | 93012-5303
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. REBECCA MATALON
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Credential | PT, DPT
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Telephone | 818-261-0567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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