Organization Active NPI

Elizabeth Logue Physical Therapy.Inc

  • Geriatric Physical Therapist
  • Huntington Beach, CA
National Provider Identifier
1548397474
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
21503 Issued in CA
Legal business name
ELIZABETH LOGUE PHYSICAL THERAPY.INC
Practice address
121 19TH St Apt 15
Huntington Beach, CA 92648-3945
Phone
(657) 464-9628
Fax
(714) 594-3830
NPI assigned
Feb 27, 2007
Last updated
Jul 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Authorized official

Name
Ms. Elizabeth Ann Logue, P. T.NPI 1962539809
Title
President
Phone
(657) 464-9628

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251G0304X 21503 CA Primary

Addresses

Primary practice location

121 19TH St Apt 15
Huntington Beach, CA 92648-3945

Mailing address

121 19TH St Apt 15
Huntington Beach, CA 92648-3945
Phone (657) 464-9628

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309824000000",
    "number": "1548397474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 19TH ST APT 15",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926483945",
            "telephone_number": "657-464-9628",
            "fax_number": "714-594-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 19TH ST APT 15",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926483945",
            "telephone_number": "657-464-9628",
            "fax_number": "714-594-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH LOGUE PHYSICAL THERAPY.INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2011-07-05",
        "status": "A",
        "authorized_official_last_name": "LOGUE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "657-464-9628",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P. T."
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "21503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.