Provider Demographics
NPI:1124020391
Name:MORRIS, PETER J (MPT)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N BATAVIA ST STE E
Mailing Address - Street 2:#519
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5531
Mailing Address - Country:US
Mailing Address - Phone:714-939-6200
Mailing Address - Fax:714-939-6500
Practice Address - Street 1:1590 S SINCLAIR ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-5933
Practice Address - Country:US
Practice Address - Phone:714-939-6200
Practice Address - Fax:714-939-6500
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26080225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14652Medicare ID - Type UnspecifiedMEDICARE GROUP ID NUMBER
CAWPT26080AMedicare PIN