NPIMap

Organization Active NPI

Pack Physical Therapy

  • Physical Therapy Clinic/Center
  • Dana Point, CA
National Provider Identifier
1750537585
Registry record updated Oct 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
28869 Issued in CA
Legal business name
PACK PHYSICAL THERAPY
Practice address
24582 Del Prado Ste E
Dana Point, CA 92629-3820
Phone
(949) 443-0713
NPI assigned
Aug 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2008

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

Authorized official

Name
Brodie James PackNPI 1871578203
Title
Owner
Phone
(949) 443-0713

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 28869 CA Primary

Addresses

Primary practice location

24582 Del Prado Ste E
Dana Point, CA 92629-3820

Mailing address

PO Box 3255
Dana Point, CA 92629-8255
Phone (949) 443-0713

National Provider Directory

National Provider Directory

Locations

24582 Del Prado
Ste E
Dana Point, CA 92629
Phone (949) 429-2155

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225065600000",
    "number": "1750537585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3255",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926298255",
            "telephone_number": "949-443-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24582 DEL PRADO STE E",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926293820",
            "telephone_number": "949-443-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACK PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-10-27",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "BRODIE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-443-0713"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "28869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dana Point, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2008; 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.