New Light Physical Therapy and Wellness Center Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

20329 Issued in CA

Legal business name

NEW LIGHT PHYSICAL THERAPY AND WELLNESS CENTER INC.

Practice address

62 Corporate Park
Suite # 235
Irvine, CA 92606-3122

Phone

(949) 878-6792

NPI assigned

Apr 15, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Ali Etessam, DPT

Title

Ceo

Phone

(949) 878-6792

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1902225212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CORPORATE PARK STE 165",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926065161",
            "telephone_number": "949-878-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 CORPORATE PARK",
            "address_2": "SUITE # 235",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926063122",
            "telephone_number": "949-878-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIGHT PHYSICAL THERAPY AND WELLNESS CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "ETESSAM",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-878-6792",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "20329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1558403733",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgiana Neuser, OTD, OTR/L
• Aaron Neustadt, M.D.
• Nicole Charlotte Nevitt, MS, LGC
• New Life Psychology Group, Inc.
• New Life Wellness LLC (Dantian Wellness)
• New Skin and Body Aesthetics Inc
• New Start Acupuncture and Herbs Inc
• Christopher Ryan New
• Salena Elizabeth Newcomb
• Dean Alexander Newcombe, DC

• Physical Therapy Clinic/Center in Irvine, CA
• Providers in Irvine, 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 16, 2021; 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.