MEDICARE: OPTC,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	:	1871562744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTC,INC

Provider Business Mailing Address
First Line	:	2200 PACIFIC COAST HWY
Second Line	:	SUITE 218
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-2757
Country	:	US
Telephone Number	:	310-937-8600
Fax Number	:	310-937-9769

Provider Business Practice Location Address
First Line	:	2200 PACIFIC COAST HWY
Second Line	:	SUITE 218
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-2757
Country	:	US
Telephone Number	:	310-937-8600
Fax Number	:	310-937-9769

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	CRISTINA CARMEN GABOR
Credential	:
Telephone Number	:	310-937-8600

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	08/22/2020

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Directions to “OPTC,INC ” Practice Location

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