Park Medical Physical Therapy, Prof Corp

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

PT7388 Issued in CA

Legal business name

PARK MEDICAL PHYSICAL THERAPY, PROF CORP

Practice address

4120 W Point Loma Blvd
San Diego, CA 92110-5605

Phone

(619) 297-2544

Fax

(619) 297-2752

NPI assigned

Feb 22, 2008

Organization subpart

No

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

Authorized official

Name

Linda Joyce Christensen, PT

Title

President/Owner

Phone

(619) 297-2544

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1295904308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4136 BACHMAN PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032028",
            "telephone_number": "619-297-2544",
            "fax_number": "619-297-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 W POINT LOMA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105605",
            "telephone_number": "619-297-2544",
            "fax_number": "619-297-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK MEDICAL PHYSICAL THERAPY, PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "JOYCE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "619-297-2544",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "PT7388",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "PT7388",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "PT7388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Park Medical Physical Therapy, Prof Corp
• Park Medical Supplies, Inc
• Park Optometry, Inc
• Park Row Podiatry Inc.
• Aaron Park

• Prosthetic/Orthotic Supplier in San Diego, CA
• Providers in San Diego, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.