Mary K. Callaway, P.T.

Individual provider Active NPI Physical Therapist · La Palma, CA

NPI 1144352188 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1144352188
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT 17838 (CA)
Practice address
7851 Walker St
Suite 202
La Palma, CA 90623-1747
Phone
(714) 739-4941
Fax
(714) 670-8711
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Palma Physical Therapy and Sports Medicine Corporation (2 clinicians)

Practice addresses (Care Compare)

7851 Walker St
Suite 202
La Palma, CA 90623-1746
Phone (626) 674-1919

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120412000301 CA Practitioner - Physical Therapist in Private Practice 3274794623 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT 17838CAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 17838 CA Yes

Addresses

Primary practice location

7851 Walker St
Suite 202
La Palma, CA 90623-1747

Mailing address

1740 Harding Ave
Altadena, CA 91001-3608
Phone (714) 739-4941

Other providers in La Palma, CA

All providers in La Palma, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.