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General NPI Number Information
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NPI Number | 1821556689
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Entity Type | Organization
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Legal Business Name | TOP TIER REHAB & PERFORMANCE
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 45 TULARE DR
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City | ALISO VIEJO
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State | CA
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Zip | 92656-8084
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Country | US
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Telephone | 909-569-3903
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Fax |
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Provider Business Mailing Address
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Address Line | 45 TULARE DR
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City | ALISO VIEJO
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State | CA
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Zip | 92656-8084
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Country | US
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Telephone | 909-569-3903
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/ATHLETIC TRAINER
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Name | DIANA YORAY WANG
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Credential | PT, DPT, ATC
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Telephone | 909-569-3903
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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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