Organization
CORE PERFORMANCE PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BOGART (CREDENTIALING SPECIALIST)
(800) 294-7001
Entity
Organization
Contact information
Practice address
15 CORPORATE PLAZA DR, SUITE 130, NEWPORT BEACH, CA 92660-7918
(213) 925-8413
Mailing address
11 ALISAL CT, ALISO VIEJO, CA 92656-1850
(213) 925-8143
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
25614
CA
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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