The Body Lab Physical Therapy Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

19911 Issued in CA

Legal business name

THE BODY LAB PHYSICAL THERAPY INC.

Practice address

2900 Bristol St
J104
Costa Mesa, CA 92626-5981

Phone

(949) 955-3100

NPI assigned

Jun 22, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Carmen Hunt

Title

Clerical

Phone

(949) 955-3100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1558712448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST",
            "address_2": "J104",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265981",
            "telephone_number": "949-955-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST",
            "address_2": "J104",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265981",
            "telephone_number": "949-955-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BODY LAB PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CLERICAL",
        "authorized_official_telephone_number": "949-955-3100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "19911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Costa Mesa, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.