Coastline Physical Therapy, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

COASTLINE PHYSICAL THERAPY, INC

Practice address

4130 N Viking Way Ste 100
Long Beach, CA 90808-1408

Phone

(562) 304-9916

NPI assigned

Oct 6, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Shannon Ludloff, PT

Title

Ceo

Phone

(562) 304-9916

Specialties & licenses 1

Addresses

Other names 1

• Coastline PT Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1043935638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 N VIKING WAY STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081408",
            "telephone_number": "562-304-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 N VIKING WAY STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081408",
            "telephone_number": "562-304-9916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11180 Warner Ave Ste 271",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087516",
            "country_code": "US",
            "telephone_number": "562-303-9916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTLINE PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "LUDLOFF",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-304-9916",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastline PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physical Therapist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.