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General NPI Number Information
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NPI Number | 1629865241
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Entity Type | Organization
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Legal Business Name | PINNACLE SPORTS PHYSICAL THERAPY & PERFORMANCE
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 1730 E HOLLY AVE STE 605
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4404
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Country | US
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Telephone | 310-776-7574
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Fax |
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Provider Business Mailing Address
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Address Line | 1730 E HOLLY AVE STE 605
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4404
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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 | MATTHEW BEATY
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Credential | PT
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Telephone | 619-730-5014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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