Individual
MICHAEL S MONNAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
800 CORPORATE DR, STE 190, LADERA RANCH, CA 92694-1152
(949) 218-0790
(949) 218-0791
Mailing address
800 CORPORATE DR, STE 190, LADERA RANCH, CA 92694-1152
(949) 218-0790
(949) 218-0791
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT16943
CA
2251G0304X
Geriatric Physical Therapist
PT16943
CA
2251S0007X
Sports Physical Therapist
PT16943
CA
2251X0800X
Orthopedic Physical Therapist
Primary
PT16943
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT169430
BLUE SHIELD
CA
Enumeration date
01/02/2008
Last updated
06/04/2020
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