Wave Physical Therapy Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

WAVE PHYSICAL THERAPY INC

Practice address

15632 Bear Valley Rd Ste 108
Victorville, CA 92395-8518

Phone

(760) 552-4230

Fax

(760) 245-8855

NPI assigned

Oct 2, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Navdeep Loomba, MD

Title

Ceo

Phone

(760) 552-4230

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy Lee, DPT

  • Orthopedic Physical Therapist
  • Victorville, CA
  • NPI 1326523929
  NPD (past)

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538438400000",
    "number": "1497230759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15632 BEAR VALLEY RD STE 108",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958518",
            "telephone_number": "760-552-4230",
            "fax_number": "760-245-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15632 BEAR VALLEY RD STE 108",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958518",
            "telephone_number": "760-552-4230",
            "fax_number": "760-245-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVE PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A",
        "authorized_official_last_name": "LOOMBA",
        "authorized_official_first_name": "NAVDEEP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-552-4230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9717838",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Watson Family Service
• Jerome Everette Watson Sr., LMFT
• Miriam Watson
• Murque Shaketa Watson, LMFT
• Nyree Watson, LMFT
• Waves of Life Counseling
• Paige Weathersby, PHARMD
• Darlene Weaver
• Melvin Webb, M.D.
• Glenn P. Wedeen, M.D.

• Physical Therapist in Victorville, CA
• Providers in Victorville, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.