Provider Demographics
NPI:1639347503
Name:HELMS, HENRY ALLEN (PT)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:ALLEN
Last Name:HELMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 HARBOR BLVD STE D1
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-1519
Mailing Address - Country:US
Mailing Address - Phone:714-542-6646
Mailing Address - Fax:714-542-6656
Practice Address - Street 1:3303 HARBOR BLVD STE D1
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-1519
Practice Address - Country:US
Practice Address - Phone:714-542-6646
Practice Address - Fax:714-542-6656
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1497737522OtherCORPORATE NPI
CAGPT000640Medicaid
1497737522OtherCORPORATE NPI