IMPACT PHYSICAL THERAPY AND PERFORMANCE, P.C. (NPI# 1346706025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346706025 |
| Entity Type | Organization |
| Organization Name | IMPACT PHYSICAL THERAPY AND PERFORMANCE, P.C. |
| Other Organization Name | KO GOLF PERFORMANCE AND PHYSICAL THERAPY, P.C. |
| Practice Address |
34 Serenity Ln Laguna Niguel CA 92677-5905 |
| Practice Telephone | 9493789985 |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2020-06-12 |
| Authorized Official Name | KEVIN JOHN O'CONNOR (OWNER - PHYSICAL THERAPIST) |
| Authorized Official Telephone | 9493789985 |
| Authorized Official Credential | PT, DPT, OCS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| KO Golf Performance and Physical Therapy, P.C. | Former Legal Business Name - Organization |
| Street Address |
34 SERENITY LN |
| City | LAGUNA NIGUEL |
| State | CA |
| Zip Code | 92677-5905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063978740 | Ak Physical Therapy, P.C. | Physical Therapist | 34 Serenity Ln, Laguna Niguel, CA 92677-5905 | 2019-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114566049 | Amber Kramer | Physical Therapist | 30100 Town Center Drive #yz, Laguna Niguel, CA 92677 | 2019-12-23 |
| 1811548340 | Morgan Peikar | Rehabilitation Hospital | 28441 Springfield Dr, Laguna Niguel, CA 92677 | 2019-09-25 |
| 1871056382 | Jacqueline Evamarie Serrano | Chiropractor | 28062 Forbes Road, Laguna Niguel, CA 92677 | 2019-04-11 |
| 1316408859 | Azadeh Ghafari | Social Worker | 30100 Town Center Dr # 179, Laguna Niguel, CA 92677 | 2019-03-27 |
| 1346741857 | Diana Wang | Physical Medicine & Rehabilitation | 30100 Town Center Drive Suite, Suite Yz, Laguna Niguel, CA 92677 | 2018-02-21 |
| 1750833554 | James H. Tran Dds, Dental Corp. | Dentist | 23876 Aliso Creek Road, Laguna Niguel, CA 92677 | 2016-10-27 |
| 1215486139 | Kevin Sun | Dentist | 49 Blue Horizon, Laguna Niguel, CA 92677 | 2016-10-04 |
| 1740637842 | Michael Dacosta | Dentist | 28862 Calle Vista, Laguna Niguel, CA 92677 | 2016-05-18 |
| 1235590373 | Adrian Gomez | Counselor | 24361 Nugget Falls Ln, Laguna Niguel, CA 92677 | 2016-03-17 |
| 1427455906 | Gracie Heart Home Health LLC | Home Health | 24318 El Pilar, Laguna Niguel, CA 92677 | 2014-11-26 |
| Find all providers in zip 92677 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174157762 | Frances Leong | Physical Therapist | 4 Mykonos, Laguna Niguel, CA 92677-8905 | 2020-02-24 |
| 1063978740 | Ak Physical Therapy, P.C. | Physical Therapist | 34 Serenity Ln, Laguna Niguel, CA 92677-5905 | 2019-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063311 | Kayla Utley | Physical Therapist | 5201 Norris Canyon Rd Ste 230, San Ramon, CA 94583-5405 | 2020-11-06 |
| 1184225054 | Vuk Ekmecic | Physical Therapist | 7908 Rancho Fanita Dr Spc 23, Santee, CA 92071-3421 | 2020-11-05 |
| 1932700283 | Christopher Lui | Physical Therapist | 21621 E Bluebell Ct, Walnut, CA 91789-1443 | 2020-11-03 |
| 1952900789 | Sierra Speck | Physical Therapist | 11701 Wilshire Blvd Ste 14b1, Los Angeles, CA 90025-1547 | 2020-10-22 |
| 1992312086 | Heidi Lynne Anders | Physical Therapist | 5805 W 8th St Apt 205, Los Angeles, CA 90036-4576 | 2020-09-23 |
| 1578176780 | Patricia Isabella Commer | Physical Therapist | 4146 Randolph Ave, Oakland, CA 94602-1314 | 2020-08-26 |
| 1376151126 | Yifu Zhou | Physical Therapist | 1625 W Olympic Blvd Ste 790, Los Angeles, CA 90015-3809 | 2020-07-17 |
| 1033732250 | Sync Physical Therapy & Yoga Inc | Physical Therapist | 5100 Marlborough Dr Ste 101, San Diego, CA 92116-2020 | 2020-05-21 |
| 1043830961 | Dr. Holly Physical Therapy | Physical Therapist | 4500 Shepard St, Bakersfield, CA 93313-2326 | 2020-04-21 |
| 1861011744 | Lauren Jarmusz | Physical Therapist | 1107 2nd Ave Apt 408, Redwood City, CA 94063-4036 | 2020-04-10 |
| Find all providers with the same taxonomy | ||||
| City | LAGUNA NIGUEL |
| Zip Code | 92677 |
Please comment or provide details below to improve the information on IMPACT PHYSICAL THERAPY AND PERFORMANCE, P.C..
| 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.