Organization Name: | COSTA REHAB AND WELLNESS CLINIC |
NPI Number: | 1730588575 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CARY COSTA (CEO) |
Mailing Address: | 22821 Lake Forest Dr Suite 115 Lake Forest |
State: | CA US |
Postal Code: | 926301606 |
Phone Number: | 9497165050 |
Fax Number: | 9494822122 |
NPI Enumeration Date: | 08/18/2014 |
NPI Last Update Date: | 04/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT37671 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |