MEDICARE: DR. PAIGE LAUREN STEPHENS PT, DPT

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	PT299031	CA
2	208100000X	Physical Medicine & Rehabilitation Physician	PT299031	CA

General Provider Information

NPI Number	:	1699381517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAIGE LAUREN STEPHENS PT, DPT

Provider Business Mailing Address
First Line	:	1600 W COAST HWY
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-5000
Country	:	US
Telephone Number	:	949-272-3325
Fax Number	:	949-333-2962

Provider Business Practice Location Address
First Line	:	6961 LOS AMIGOS CIR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-6659
Country	:	US
Telephone Number	:	714-841-5440
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2020
Last Update Date	:	09/25/2022

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