Southern California Sports Rehab Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SOUTHERN CALIFORNIA SPORTS REHAB INC

Practice address

2428 Grand Avenue
Suite E
Santa Ana, CA 92705

Phone

(949) 863-0022

Fax

(949) 863-0023

NPI assigned

Oct 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David Conrad

Title

Cfo

Phone

(949) 863-0022

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Philip Cordova, PT

  • Physical Therapist
  • Hawthorne, CA
  • NPI 1063598761
  NPD (past)
• David L Macayaon

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1083988554
  NPD (past)
• Dominic Peter Toscano, RPT

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1801210042
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659457364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 E DYER ROAD",
            "address_2": "SUITE 311",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92705",
            "telephone_number": "949-863-0022",
            "fax_number": "949-863-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 GRAND AVENUE",
            "address_2": "SUITE E",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92705",
            "telephone_number": "949-863-0022",
            "fax_number": "949-863-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA SPORTS REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "949-863-0022",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Southard
• Southern California Dermatology, Inc
• Southern California Medical Specialists, Inc.
• Southern California Prosthetics, Inc.
• Southern California Specialty Care, LLC
• Southern California Sports Rehabilitation, Inc.
• Southland Integrated Services, Inc. (Integrated Community Services - Santa Ana)
• Praseuth Souvannavong
• Soyeon Kim (Kim's Dental Corporation)
• Anissa Ellen Spada, NURSE PRACTITIONER

• Physical Therapy Clinic/Center in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.