Organization
LAGUNA BEACH REHAB INC
Active
Organization
LAGUNA BEACH REHAB INC
Active
Other names
Laguna Beach Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL M FRACALOSY P.T. (OWNER)
(949) 499-9559
Entity
Organization
Contact information
Practice address
31852 S. COAST HIGHWAY, STE. 303, LAGUNA BEACH, CA 92651
(949) 499-9559
(949) 499-1845
Mailing address
31852 S. COAST HIGHWAY, STE. 303, LAGUNA BEACH, CA 92651
(949) 499-9559
(949) 499-1845
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
133949
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W19811
MEDICARE PTAN
CA
Enumeration date
05/12/2006
Last updated
07/21/2022
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