Lucille Lopez Wagner R.P.T., Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT6997 Issued in CA

Legal business name

LUCILLE LOPEZ WAGNER R.P.T., INC.

Doing business as

Orange Coast Physical Therapy

Practice address

17456 Beach Blvd
Huntington Beach, CA 92647-5913

Phone

(714) 841-2688

Fax

(714) 841-2688

NPI assigned

May 15, 2007

Last updated

Aug 29, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Lucille Lopez Wagner, P.T., L.AC.

Title

President

Phone

(714) 841-2688

Specialties & licenses 1

Addresses

Other names 1

• Orange Coast Physical Therapy Doing business as

Locations

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283040000000",
    "number": "1225244130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3079 NESTALL RD",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512026",
            "telephone_number": "949-497-8227",
            "fax_number": "714-841-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17456 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475913",
            "telephone_number": "714-841-2688",
            "fax_number": "714-841-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCILLE LOPEZ WAGNER R.P.T., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2010-08-29",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "LUCILLE",
        "authorized_official_middle_name": "LOPEZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-841-2688",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P.T., L.AC."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT6997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orange Coast Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luc Aura Mental Health Nursing Corp
• Cristian Lucas
• Denella Lucero, M.F.T.
• Kayla Lucero
• Daniel Lucey
• Lucretia a. Reed
• Julia Ludwig-Bongard, M.A.
• Emily Ludwig, PA-C
• Alexis Luevano
• Ileana Lugo

• Specialist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2010; 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.