Community Physical Therapy and Performance, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

COMMUNITY PHYSICAL THERAPY AND PERFORMANCE, INC

Practice address

2969 Century PL
Costa Mesa, CA 92626-4323

Phone

(206) 999-9153

NPI assigned

Jun 22, 2024

Organization subpart

No

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

Authorized official

Name

Kellen Matsuno, DPTNPI 1124509542

Title

Ceo

Phone

(206) 999-9153

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.

• Kellen Matsuno, DPT

  • Physical Therapist
  • Costa Mesa, CA
  • NPI 1124509542
  NPD Authorized official

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719014400000",
    "number": "1801630074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4139 E 11TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908044255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2969 CENTURY PL",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264323",
            "telephone_number": "206-999-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHYSICAL THERAPY AND PERFORMANCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A",
        "authorized_official_last_name": "MATSUNO",
        "authorized_official_first_name": "KELLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-999-9153",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freddie Joe Combs Jr., M.D.
• Comfort RX, LLC
• Comfygo, Inc
• Community Diagnostics LLC
• Community Mental Health Corp
• Ynnafranchesca Pango Comodero
• Competent Care Home Health Nursing
• Competent Caregiving
• Complete Spine and Wellness Group, Inc
• Annette Conde, BCBA

• Physical Therapy Clinic/Center in Costa Mesa, CA
• Providers in Costa Mesa, 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 Jun 22, 2024; 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.