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Organization
WATERFRONT FITNESS & NUTRITION
Active
Organization
WATERFRONT FITNESS & NUTRITION
Active
Other names
Pro PT
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN SANTOS P.T. (PHYSICAL THERAPIST/OWNER)
(949) 598-9315
Entity
Organization
Contact information
Practice address
27725 SANTA MARGARITA PKWY STE 210, MISSION VIEJO, CA 92691-6710
(949) 598-9315
(949) 598-9439
Mailing address
27725 SANTA MARGARITA PKWY STE 210, MISSION VIEJO, CA 92691-6710
(949) 598-9315
(949) 598-9439
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W15346
MEDICARE
CA
Enumeration date
03/11/2008
Last updated
05/24/2012
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