Fyziogym Physical Therapy of California Corp

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FYZIOGYM PHYSICAL THERAPY OF CALIFORNIA CORP

Practice address

16331 Gothard St
Huntington Beach, CA 92647-3664

Phone

(714) 690-0385

NPI assigned

Sep 10, 2019

Organization subpart

No

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

Authorized official

Name

Lyneil Mitchell, PT

Title

Owner

Phone

(814) 881-4717

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1790334878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 PACIFIC COAST HWY UNIT 323",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926485053",
            "telephone_number": "814-881-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16331 GOTHARD ST",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473664",
            "telephone_number": "714-690-0385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FYZIOGYM PHYSICAL THERAPY OF CALIFORNIA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "LYNEIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-881-4717",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drlyneil46@fyziogym.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "address_1": "16331 Gothard St",
            "city": "Huntington Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926473664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Huntington Beach, CA
• Providers in Huntington Beach, 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 Sep 10, 2019; 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.