Organization Active NPI

Eastbluff Physical Rehabilitation, Inc.

  • Orthopedic Physical Therapist
  • Corona del Mar, CA
National Provider Identifier
1073633384
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
EASTBLUFF PHYSICAL REHABILITATION, INC.
Practice address
2600 East Pacific Coast Highway
Suite 240
Corona del Mar, CA 92625
Phone
(949) 760-9545
Fax
(714) 968-4220
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Miss Dorothy Irene Lucchesi
Title
Vice President
Phone
(949) 760-9545

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ergonomics Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251E1200X CA
Hand Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251H1200X CA
Sports Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251S0007X CA
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X CA Primary

Addresses

Primary practice location

2600 East Pacific Coast Highway
Suite 240
Corona del Mar, CA 92625

Mailing address

301 Vista Suerte
Newport Beach, CA 92660-3516
Phone (949) 760-9545

National Provider Directory

National Provider Directory

Locations

3931 Birch St
Ste 2
Newport Beach, CA 92660

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1073633384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 VISTA SUERTE",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926603516",
            "telephone_number": "949-760-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 EAST PACIFIC COAST HIGHWAY",
            "address_2": "SUITE 240",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "92625",
            "telephone_number": "949-760-9545",
            "fax_number": "714-968-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTBLUFF PHYSICAL REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LUCCHESI",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "949-760-9545",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "2251E1200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Ergonomics",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Hand",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona del Mar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.