DYNAMIC SPINE AND SPORT PHYSICAL THERAPY, P.C. (NPI# 1275979585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275979585 |
| Entity Type | Organization |
| Organization Name | DYNAMIC SPINE AND SPORT PHYSICAL THERAPY, P.C. |
| Practice Address |
902 N Grand Ave Suite 100 Santa Ana CA 92701-4218 |
| Practice Telephone | 7142631834 |
| Practice Fax Number | 7142631835 |
| Mailing Telephone | 7142631834 |
| Mailing Fax Number | 7142631835 |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2013-05-14 |
| Authorized Official Name | JORDAN JESSE TURNER (PRESIDENT) |
| Authorized Official Telephone | 7142631834 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | PT22810 | CA | Other Service Providers |
| Street Address |
902 N GRAND AVE SUITE 100 |
| City | SANTA ANA |
| State | CA |
| Zip Code | 92701-4218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134218969 | Brock Victor Nyquist | Nurse Anesthetist, Certified Registered | 902 N Grand Ave, Santa Ana, CA 92701-4218 | 2006-10-12 |
| 1275700478 | Samer Moghaddam | Internal Medicine | 902 N Grand Ave, Santa Ana, CA 92701-4218 | 2008-05-15 |
| 1780874222 | A Michael Moheimani Md Inc | Orthopaedic Surgery | 902 N Grand Ave, Santa Ana, CA 92701-4218 | 2007-07-31 |
| 1376665737 | Mark Anthony Knight | Surgery | 902 N Grand Ave, Suite 100, Santa Ana, CA 92701-4218 | 2007-04-05 |
| 1639253131 | A Michael Moheimani | Orthopaedic Surgery | 902 N Grand Ave, Ste 100, Santa Ana, CA 92701-4223 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841807401 | Midori K Dirig | Psychologist | 405 W. 3rd Street, Santa Ana, CA 92701 | 2020-09-28 |
| 1952915456 | Alexandria Bekele | Counselor | Address: 405 W. 5th Street, Santa Ana, CA 92701 | 2020-09-02 |
| 1508479239 | Candice Bjorkman | Counselor | 1201 E Fruit St, Santa Ana, CA 92701 | 2020-08-24 |
| 1013527365 | Maryiam Elizabeth Barkho | Dentist | 809 South Main Street Suite B, Santa Ana, CA 92701 | 2020-08-02 |
| 1447803788 | Emmett Eugene Cook II | Counselor | 1207 E Fruit Street, Santa Ana, CA 92701 | 2019-07-16 |
| 1619538741 | Emily H Sanders | Marriage & Family Therapist | 1800-f Parkcourt Place, Suite 205, Santa Ana, CA 92701 | 2019-06-28 |
| 1184191769 | Peace of Mind Wellness & Family Counseling, Inc. | Counselor | 1651 E. Fourth St Ste 240, Santa Ana, CA 92701 | 2018-10-31 |
| 1841765815 | Kelly Marie Contreras | Clinical Medical Laboratory | 902 N. Grand Avenue, Suite 204, Santa Ana, CA 92701 | 2018-10-05 |
| 1780176537 | Diane Carol Navarro-prescott | Counselor | 1633 East 4th Street, Santa Ana, CA 92701 | 2018-06-06 |
| 1750873758 | Eileen Fernandez | Counselor | 615 W Civic Center Dr Fl 2, Santa Ana, CA 92701 | 2018-06-05 |
| Find all providers in zip 92701 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972003325 | Joanie S Gonella | Specialist | 1780 E Mcfadden Ave Ste 115, Santa Ana, CA 92705-4648 | 2018-02-12 |
| 1588906390 | Consuelo Merce' Edwards | Specialist | 1391 Faren Dr, Santa Ana, CA 92705-2451 | 2013-03-19 |
| 1225370133 | Andrea Dunkelman, Md Inc. A Medical Corporation | Specialist | 1710 La Loma Dr, Santa Ana, CA 92705-3027 | 2013-03-19 |
| 1689916595 | Alfredo Zarate | Specialist | 13671 Yellowstone Dr, Santa Ana, CA 92705-2657 | 2013-03-19 |
| 1407194624 | Hamid U. Rahman, M.d., F.r.c.s., Inc. | Specialist | 1220 Hemlock Way Ste 203, Santa Ana, CA 92707-3655 | 2013-01-23 |
| 1053678920 | Ebrahim Duel M.d. Inc | Specialist | 301 N. Main Sreet, Santa Ana, CA 92701-4852 | 2012-04-17 |
| 1326313560 | Enriqueta Silva | Specialist | 1110 W 21st St, Santa Ana, CA 92706-3530 | 2012-03-21 |
| 1205146156 | N Charle Morcos Md Phd Inc | Specialist | 999 N Tustin Ste 15, Santa Ana, CA 92705-3530 | 2010-10-13 |
| 1518277516 | Hector J. Fernandez, M.d. Inc | Specialist | 1970 Old Tustin Ave, Santa Ana, CA 92705-7865 | 2010-10-09 |
| 1639485543 | Marilyn G. Myers, M.d., Apc | Specialist | 2220 E Fruit St Ste 217, Santa Ana, CA 92701-4459 | 2010-08-30 |
| Find all providers in SANTA ANA | ||||
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| 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.