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Organization
PERSONAL CARE PHYSICAL THERAPY, INC
Active
Organization
PERSONAL CARE PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON FAVIS SAMONTE MPT (CEO)
(562) 522-1111
Entity
Organization
Contact information
Practice address
357 AQUA WAY, BREA, CA 92821
(562) 522-1111
Mailing address
357 AQUA WAY, BREA, CA 92821-2161
(562) 522-1111
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT27960
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT27960
MEDICARE PROVIDER
CA
Enumeration date
10/17/2007
Last updated
01/03/2019
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