Peter W McCann, P.T.

Individual provider Active NPI Physical Therapist · Gualala, CA

NPI 1215004288 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1215004288
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
00PT6431 (CA)
Practice address
39120 Cypress Way
Gualala, CA 95445-8310
Phone
(707) 884-4800
Fax
(707) 884-4808
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
Yes

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 participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
00PT6431CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lucinda Weaver Physical Therapy Current
since Sep 1, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 00PT6431 CA Yes

Addresses

Primary practice location

39120 Cypress Way
Gualala, CA 95445-8310

Mailing address

39120 Cypress Way
Gualala, CA 95445-8310
Phone (707) 884-4800

Other providers in Gualala, CA

All providers in Gualala, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.