| Organization Name: | INTECORE INC |
| NPI Number: | 1215104070 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARTIN ANDREW VERTSON (OWNER) |
| Mailing Address: | 26741 Portola Pkwy # 1e-630 Foothill Ranch |
| State: | CA US |
| Postal Code: | 926101743 |
| Phone Number: | 9495972103 |
| Fax Number: | |
| NPI Enumeration Date: | 05/12/2008 |
| NPI Last Update Date: | 05/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | PT21687 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |