MEDICARE: WEST STAR 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1376764571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST STAR PHYSICAL THERAPY, INC.

Provider Business Mailing Address
First Line	:	PO BOX 6209
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92846-6209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12062 VALLEY VIEW ST STE 200
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-1739
Country	:	US
Telephone Number	:	714-827-4822
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	GEOFFREY SUNDSTROM
Credential	:
Telephone Number	:	714-827-4822

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	04/16/2024

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