Executive Wellness

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

EXECUTIVE WELLNESS

Practice address

8 Quail Ridge Rd S
Rolling Hills, CA 90274-5017

Phone

(310) 218-2600

Fax

(310) 541-8280

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Casey Edward MaguireNPI 1467557348

Title

Owner

Phone

(310) 218-2600

Specialties & licenses 1

Addresses

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

• Casey Edward Maguire, PHYSICAL THERAPIST

  • Physical Therapist
  • Rolling Hills, CA
  • NPI 1467557348
  NPD (past) Authorized official

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508961400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14155",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928631555",
            "telephone_number": "310-218-2600",
            "fax_number": "310-541-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 QUAIL RIDGE RD S",
            "city": "ROLLING HILLS",
            "state": "CA",
            "postal_code": "902745017",
            "telephone_number": "310-218-2600",
            "fax_number": "310-541-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAGUIRE",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-218-2600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Ayoub, DDS
• Kathleen Carvalho-Bacalan, PHARM D
• Russell F Coser, D.D.S.
• Natalie David, LCSW
• Ineurology, PC
• Debra Davis Kinkelaar, LCSW
• Dora Rachel Kram, RD
• Rosemary Leake, M.D.
• Ryan Livian

• All providers in Rolling Hills, CA
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.