Provider Demographics
NPI:1407002561
Name:PT PLUS REHAB, INC
Entity Type:Organization
Organization Name:PT PLUS REHAB, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-595-8635
Mailing Address - Street 1:24 HAMMOND
Mailing Address - Street 2:UNIT C
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1680
Mailing Address - Country:US
Mailing Address - Phone:949-770-6022
Mailing Address - Fax:949-770-7084
Practice Address - Street 1:7860 IMPERIAL HWY
Practice Address - Street 2:C
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-3464
Practice Address - Country:US
Practice Address - Phone:562-869-8525
Practice Address - Fax:562-866-7786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3121618261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy