Provider Demographics
NPI:1174848055
Name:OC PHYSICAL THERAPY CORPORATION
Entity Type:Organization
Organization Name:OC PHYSICAL THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIAO-LAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:949-333-2224
Mailing Address - Street 1:18102 SKY PARK CIR
Mailing Address - Street 2:#C
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6531
Mailing Address - Country:US
Mailing Address - Phone:949-502-3300
Mailing Address - Fax:949-333-2225
Practice Address - Street 1:62 COPORATE PARK
Practice Address - Street 2:145
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606
Practice Address - Country:US
Practice Address - Phone:949-333-2224
Practice Address - Fax:949-333-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-02
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy