Fortunato David Azoulay, M.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 21389 Issued in CA

Practice address

17595 Harvard Ave Ste C
Irvine, CA 92614-8522

Phone

(949) 233-1980

NPI assigned

Sep 11, 2008

Last updated

Sep 11, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maxum Physical Therapy Inc

  • Physical Therapist
  • Placentia, CA
  • NPI 1629002936
  NPD
• Grace Physical Therapy, Inc.

  dba Laguna Orthopedic Rehabilitation

  • Specialist
  • Laguna Niguel, CA
  • NPI 1386668739
  NPD (past)
• Interface Rehab, Inc.

  • Physical Disabilities Residential Treatment Facility
  • Placentia, CA
  • NPI 1306960851
  NPD (past)
• Michael Gillman M D Inc

  • Orthopedic Physical Therapist
  • Laguna Beach, CA
  • NPI 1376737353
  NPD (past)

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1053560276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17595 HARVARD AVE STE C",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926148522",
            "telephone_number": "949-233-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17595 HARVARD AVE STE C",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926148522",
            "telephone_number": "949-233-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZOULAY",
        "first_name": "FORTUNATO",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "M.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-11",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 21389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Azari
• Farid Azhir
• Azita Mesbah MD Inc
• Khaled Hani Aziz
• Manal Michel Aziz, DDS
• Lianne Cara Phillips Azuaje
• Nicole Chinwendu Azuogu
• B & D Urrutia Corporation
• B Medical LLC
• B. Nguyen Dental Corporation (Walnut Dental Group and Orthodontics)

• Physical Therapist in Irvine, CA
• Providers in Irvine, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; 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.