Proedge Physical Therapy

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

26792 Issued in CA

Legal business name

PROEDGE PHYSICAL THERAPY

Practice address

1124 Main St
Suite C
Irvine, CA 92614-6760

Phone

(949) 679-7755

Fax

(949) 679-7755

NPI assigned

Jun 30, 2009

Organization subpart

No

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

Authorized official

Name

Sara Sogol Amoli, MPT, C.S.C.SNPI 1306934856

Title

Owner

Phone

(949) 679-7755

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Sara Sogol Amoli, MPT, CSCS

  • Orthopedic Physical Therapist
  • Irvine, CA
  • NPI 1306934856
  NPD (past) Authorized official

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1609004480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 13144",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926585086",
            "telephone_number": "949-679-7755",
            "fax_number": "949-679-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 MAIN ST",
            "address_2": "SUITE C",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146760",
            "telephone_number": "949-679-7755",
            "fax_number": "949-679-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROEDGE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "AMOLI",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "SOGOL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-679-7755",
        "authorized_official_credential": "MPT, C.S.C.S"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "26792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Physical Therapist in Irvine, CA
• Providers in Irvine, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.