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General NPI Number Information
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NPI Number | 1609074509
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Entity Type | Individual
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Provider Name | BRIAN RAYNER PT
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 229 MARINE AVE
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City | NEWPORT BEACH
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State | CA
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Zip | 92662-1247
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Country | US
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Telephone | 949-412-2850
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Fax | 949-675-3458
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Provider Business Mailing Address
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Address Line | 229 MARINE AVE
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City | NEWPORT BEACH
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State | CA
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Zip | 92662-1247
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Country | US
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Telephone | 949-412-2850
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Fax | 949-675-3458
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PT22459
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License Number State | CA
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