Madhu Manohar Wadhwa, PTO
Individual provider Active NPI Physical Therapist · Laguna Hilla, CA
NPI 1194939017 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1194939017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 9538 (CA)
- Practice address
- Rehab Alliance, 23271 Verdugo Drive
Suite B
Laguna Hilla, CA 92653-1347 - Phone
- (949) 707-5555
- NPI assigned
- May 9, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9538 | CA | MD | Neurorehabilitation Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sand Coast Rehab Physical Therapy Inc | Physical Therapist | Past |
Accepting new patients |
| Rehab Alliance | Past | Accepting new patients | |
| Rehab Alliance | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9538 | CA | Yes |
Addresses
Primary practice location
Rehab Alliance, 23271 Verdugo Drive
Suite B
Laguna Hilla, CA 92653-1347
Mailing address
11 San Mateo Way
Corona del Mar, CA 92625-1034
Phone (949) 760-9566
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.