Infinity Physical Therapy Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14295 Issued in CA

Legal business name

INFINITY PHYSICAL THERAPY INC

Practice address

12800 Garden Grove Blvd Ste F
Garden Grove, CA 92843-2008

Phone

(714) 620-8980

Fax

(714) 620-8982

NPI assigned

Aug 30, 2017

Organization subpart

No

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

Authorized official

Name

Emad Libib Samuel, RPT

Title

Director

Phone

(714) 620-8980

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1528586468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 GARDEN GROVE BLVD STE F",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928432008",
            "telephone_number": "714-620-8980",
            "fax_number": "714-620-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 GARDEN GROVE BLVD STE F",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928432008",
            "telephone_number": "714-620-8980",
            "fax_number": "714-620-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITY PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "EMAD LIBIB",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "714-620-8980",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "14295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1871748822",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.