PROSPORT PHYSICAL THERAPY PROFESSIONALS INC (NPI# 1073170437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073170437 |
| Entity Type | Organization |
| Organization Name | PROSPORT PHYSICAL THERAPY PROFESSIONALS INC |
| Practice Address |
2777 Bristol St Ste B Costa Mesa CA 92626-5997 |
| Mailing Address |
Po Box 14155 Orange CA 92863-1555 |
| Practice Telephone | 9492501112 |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-05-21 |
| Authorized Official Name | KIMBERLY KAY GORDON-SWENSON (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 7144504999 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 23001 Del Lago Dr Ste C1, Laguna Hills, CA 926531354 | 9497668535 | |
| 28924 S Western Ave Ste 101, Rancho Palos Verdes, CA 902750813 | 3105480104 | |
| 30085 Comercio, Rancho Santa Margarita, CA 926882106 | 9497668535 |
| Street Address |
2777 BRISTOL ST STE B |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-5997 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235657529 | Gabriel P Ignacio | Physical Therapist | 2777 Bristol St Ste B, Costa Mesa, CA 92626 | 2017-09-06 |
| 1841823291 | Greg Moses | Physical Therapist | 2777 Bristol St Ste B, Costa Mesa, CA 92626-5997 | 2020-02-13 |
| 1023577491 | Caroline A Teets | Physical Therapist | 2777 Bristol St Ste B, Costa Mesa, CA 92626-5997 | 2019-03-15 |
| 1528553864 | Brent A Talley | Physical Therapist | 2777 Bristol St Ste B, Costa Mesa, CA 92626 | 2018-06-28 |
| 1386136661 | Heather Ann Schinnerer | Physical Therapist | 2777 Bristol St Ste B, Costa Mesa, CA 92626 | 2018-06-03 |
| 1790296192 | Victor Vu Nguyen | Physical Therapist | 2777 Bristol St Ste B, Costa Mesa, CA 92626 | 2017-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881079259 | Coalition Physical Therapy | Clinic/Center | 121 E 18th St, Costa Mesa, CA 92627-3034 | 2015-07-27 |
| 1659624930 | Health Works Physical Therapy, Inc | Clinic/Center | 2951 Harbor Blvd, Costa Mesa, CA 92626-3912 | 2012-10-24 |
| 1447544499 | Power Physical Therapy and Sports Medicine | Clinic/Center | 3140 Red Hill Ave Ste 225, Costa Mesa, CA 92626-3440 | 2011-06-07 |
| 1982930392 | Natural Health Sports Therapy Inc | Clinic/Center | 1784 Newport Blvd, Costa Mesa, CA 92627-2756 | 2009-10-20 |
| 1578722823 | Homeworks Physical Therapy | Clinic/Center | 2012 Phalarope Ct, Costa Mesa, CA 92626-4734 | 2008-06-03 |
| 1760402515 | Ann Steinfeld Physical Therapy | Clinic/Center | 1700 Adams Ave, Suite 201, Costa Mesa, CA 92626-4865 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051839 | The Pelvic Model Physical Therapy, Inc. | Clinic/Center | 3761 Vinton Ave Apt 6, Los Angeles, CA 90034-5781 | 2020-10-18 |
| 1932707957 | Body In Motion Therapy, P.c | Clinic/Center | 1111 S Grand Ave Apt 708, Los Angeles, CA 90015-2169 | 2020-10-12 |
| 1992303275 | Vw Physical Therapy, Inc. | Clinic/Center | 100 Saybrook Ave, Vacaville, CA 95687-4129 | 2020-10-09 |
| 1730787094 | Movement System Institute Physiotherapy Inc | Clinic/Center | 508 Glenwood Rd Apt 102, Glendale, CA 91202-1572 | 2020-10-09 |
| 1538766530 | Sterling King Physical Therapy | Clinic/Center | 1820 Fullerton Ave Ste 280, Corona, CA 92881-3175 | 2020-10-03 |
| 1902403041 | Jha Geriatric Services, Inc | Clinic/Center | 12490 Fielding Circle, Suite 174, Playa Vista, CA 90094-3024 | 2020-10-01 |
| 1245847540 | Bespoke San Diego Physical Therapy PC | Clinic/Center | 2748 Ariane Dr, Unit 141, San Diego, CA 92117-3407 | 2020-09-30 |
| 1285241786 | Rapid Recovery Physical Therapy Inc | Clinic/Center | 39807 Paseo Padre Pkwy, Fremont, CA 94538-2974 | 2020-09-28 |
| 1053928697 | Bonnie Laine Lasher | Clinic/Center | 33772 Copper Lantern St Apt C, Dana Point, CA 92629-6427 | 2020-09-28 |
| 1295340792 | Naum Physical Therapy PC | Clinic/Center | 11405 Fulbourn Ct, Rancho Cucamonga, CA 91730-8341 | 2020-09-10 |
| Find all providers with the same taxonomy | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
Please comment or provide details below to improve the information on PROSPORT PHYSICAL THERAPY PROFESSIONALS INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.