Organization Active NPI

Marina Sports Rehab PC

  • Physical Therapist
  • Rancho Palos Verdes, CA
National Provider Identifier
1407649700
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MARINA SPORTS REHAB PC
Practice address
28633 S Western Ave Ste 200
Rancho Palos Verdes, CA 90275-0817
Phone
(310) 832-2622
NPI assigned
May 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Timothy Ursich Jr.NPI 1518392521
Title
Owner
Phone
(310) 339-9620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

28633 S Western Ave Ste 200
Rancho Palos Verdes, CA 90275-0817

Mailing address

28633 S Western Ave Ste 200
Rancho Palos Verdes, CA 90275-0817

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.

NPI Registry JSON

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1407649700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28633 S WESTERN AVE STE 200",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28633 S WESTERN AVE STE 200",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750817",
            "telephone_number": "310-832-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA SPORTS REHAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "URSICH",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-339-9620",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Palos Verdes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.