Organization Active NPI

Kinetics Physical Therapy Prof Corp

  • Physical Therapist
  • San Dimas, CA
National Provider Identifier
1205766714
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KINETICS PHYSICAL THERAPY PROF CORP
Practice address
406 W 5TH St
San Dimas, CA 91773-2014
Phone
(909) 288-2670
Fax
(520) 372-2043
NPI assigned
May 19, 2026
Last updated
Jul 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Authorized official

Name
Melinda Peloquin
Title
Credentialing Manager
Phone
(949) 215-5008

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Human Factors Physical Therapist 2251H1300X
Neurology Physical Therapist 2251N0400X
Orthopedic Physical Therapist 2251X0800X

Addresses

Primary practice location

406 W 5TH St
San Dimas, CA 91773-2014

Mailing address

406 W 5TH St
San Dimas, CA 91773-2014
Phone (909) 288-2670

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1779148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784246400000",
    "number": "1205766714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 W 5TH ST",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732014",
            "telephone_number": "909-288-2670",
            "fax_number": "520-372-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W 5TH ST",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732014",
            "telephone_number": "909-288-2670",
            "fax_number": "520-372-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETICS PHYSICAL THERAPY PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-19",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A",
        "authorized_official_last_name": "PELOQUIN",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "949-215-5008"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251H1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Human Factors",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.