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Organization
SAINT MARINA PHYSICAL THERAPY, INC.
Active
Organization
SAINT MARINA PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WASSIEM ABDELMALEK PHYSICAL THERAPIST (OWNER)
(949) 770-1911
Entity
Organization
Contact information
Practice address
113 WATERWORKS WAY, SUITE 230, IRVINE, CA 92618-3167
(949) 770-1911
(949) 770-1985
Mailing address
113 WATERWORKS WAY, SUITE 230, IRVINE, CA 92618-3167
(949) 770-1911
(949) 770-1985
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5623791
FIRST HEALTH
CA
01
—
7026695
AETNA
CA
01
—
ZZZ64156Z
BLUE SHIELD GROUP NUMBER
CA
Enumeration date
12/18/2006
Last updated
03/13/2012
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