MEDICARE: INTECORE, 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	21687	CA

General Provider Information

NPI Number	:	1912042714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTECORE, INC.

Provider Business Mailing Address
First Line	:	26741 PORTOLA PKWY STE 1E-630
Second Line	:
City	:	FOOTHILL RANCH
State	:	CA
Zip	:	92610-1743
Country	:	US
Telephone Number	:	949-597-2103
Fax Number	:	949-597-2061

Provider Business Practice Location Address
First Line	:	26700 TOWNE CENTRE DR STE 120
Second Line	:
City	:	FOOTHILL RANCH
State	:	CA
Zip	:	92610-2843
Country	:	US
Telephone Number	:	949-597-2103
Fax Number	:	949-597-2061

Authorized Official
Title or Position	:	PRESIDENT/PHYSICAL THERAPIST
Name	:	MARTIN ANDREW VERTSON
Credential	:	P.T., D.P.T., A.T.C.
Telephone Number	:	360-474-3274

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	06/10/2026

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