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General NPI Number Information
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NPI Number | 1609554468
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Entity Type | Organization
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Legal Business Name | MANKIND PHYSICAL THERAPY & SPORTS MEDICINE
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 17241 MURPHY AVE
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City | IRVINE
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State | CA
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Zip | 92614-5917
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Country | US
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Telephone | 949-312-1651
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Fax |
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Provider Business Mailing Address
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Address Line | 17241 MURPHY AVE
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City | IRVINE
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State | CA
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Zip | 92614-5917
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Country | US
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Telephone | 949-312-1651
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. JASON S MANALILI
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Credential | DPT, OCS, CSCS
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Telephone | 949-312-1651
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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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