Paul Robert Addison Jr., MPT, CSCS
Individual provider Active NPI Orthopedic Physical Therapist · Laguna Hills, CA
NPI 1487829933 · NPPES record last updated Feb 20, 2009
Key facts
- NPI
- 1487829933
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- License
- 34602 (CA)
- Practice address
- 26941 Cabot Rd
#103
Laguna Hills, CA 92653-7030 - Phone
- (949) 916-1402
- Fax
- (949) 916-1403
- NPI assigned
- Apr 25, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34602 | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shadow Management Services, Inc. | Orthopedic | Past | Accepting new patients |
| Restorative Therapy Associates | Orthopedic | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 34602 | CA | Yes |
Addresses
Primary practice location
26941 Cabot Rd
#103
Laguna Hills, CA 92653-7030
Mailing address
26941 Cabot Rd
#103
Laguna Hills, CA 92653-7030
Phone (949) 916-1402
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All providers in Laguna Hills, CA · Orthopedic Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.