MEDICARE: BEACH COMMUNITIES PHYSICAL THERAPY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1144375114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACH COMMUNITIES PHYSICAL THERAPY, INC.

Provider Business Mailing Address
First Line	:	2920 WESTMINSTER AVE
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-5305
Country	:	US
Telephone Number	:	562-426-2051
Fax Number	:	562-426-9525

Provider Business Practice Location Address
First Line	:	2920 WESTMINSTER AVE
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-5305
Country	:	US
Telephone Number	:	562-426-2051
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. KEVIN EUGENE SMITH
Credential	:
Telephone Number	:	562-426-2051

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	08/22/2020

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