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NPI Code Detail

MEDICARE: KYLE JORDAN PHYSICAL THERAPY CONSULTING PC

MEDICARE: KYLE JORDAN PHYSICAL THERAPY CONSULTING PC
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1396601704
Entity Type Code : Organization
Provider Name (Legal Business Name) : KYLE JORDAN PHYSICAL THERAPY CONSULTING PC
Provider Business Mailing Address
First Line : 232 AVENIDA ARAGON # B
Second Line :
City : SAN CLEMENTE
State : CA
Zip : 92672-5015
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 34207 PACIFIC COAST HWY
Second Line :
City : DANA POINT
State : CA
Zip : 92629-2849
Country : US
Telephone Number : 818-421-4745
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KYLE OLANDT
Credential :
Telephone Number : 818-421-4745
Provider Enumeration Date : 12/30/2025
Last Update Date : 12/30/2025

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Directions to “KYLE JORDAN PHYSICAL THERAPY CONSULTING PC ” Practice Location

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