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

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)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
34602CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Management Services, Inc. Orthopedic Past Accepting new patients
Restorative Therapy Associates Orthopedic Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Laguna Hills, CA

All providers in Laguna Hills, CA · Orthopedic Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.