Impact Health & Wellness LLC

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

CAMTC 20733 Issued in CA

Legal business name

IMPACT HEALTH & WELLNESS LLC

Practice address

2025 Newport Blvd
Suite 110
Costa Mesa, CA 92627-2162

Phone

(949) 954-6225

NPI assigned

Sep 21, 2011

Organization subpart

No

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

Authorized official

Name

Manuel Aragon, CMT

Title

Managing Director

Phone

(949) 954-6225

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1609159193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 NEWPORT BLVD",
            "address_2": "SUITE 110",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272162",
            "telephone_number": "949-954-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 NEWPORT BLVD",
            "address_2": "SUITE 110",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272162",
            "telephone_number": "949-954-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "ARAGON",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "949-954-6225",
        "authorized_official_credential": "CMT"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Mechanotherapist",
            "state": "CA",
            "license": "CAMTC 20733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mechanotherapist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Mechanotherapist in California

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