Pacific Coast Care Rehab Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6772 Issued in CA

Legal business name

PACIFIC COAST CARE REHAB INC.

Practice address

4154 Woodruff Ave
Lakewood, CA 90713-3141

Phone

(562) 888-0656

NPI assigned

Jan 10, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Philip Thames

Title

Director

Phone

(562) 888-0656

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1174860175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12426",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926585062",
            "telephone_number": "562-888-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4154 WOODRUFF AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907133141",
            "telephone_number": "562-888-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST CARE REHAB INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-10",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "THAMES",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "562-888-0656",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT6772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.