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General NPI Number Information
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NPI Number | 1598193294
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Entity Type | Organization
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Legal Business Name | PACIFIC COAST INSTITUTE REHAB AND PHYSICAL THERAPY INC.
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 11190 WARNER AVE SUITE 306
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4019
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Country | US
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Telephone | 714-432-9990
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Fax | 714-432-9988
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Provider Business Mailing Address
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Address Line | 11190 WARNER AVE SUITE 309
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4019
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Country | US
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Telephone | 714-432-9990
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Fax | 714-432-9988
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER CAO NINH
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Credential | M.D.
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Telephone | 714-432-9990
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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 | A98528
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License Number State | CA
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