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Organization
MARINA SPORTS REHAB PC
Active
Organization
MARINA SPORTS REHAB PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY URSICH JR. (OWNER)
(310) 339-9620
Entity
Organization
Contact information
Practice address
28633 S WESTERN AVE STE 200, RANCHO PALOS VERDES, CA 90275-0817
(310) 832-2622
Mailing address
28633 S WESTERN AVE STE 200, RANCHO PALOS VERDES, CA 90275-0817
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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