Provider Demographics
NPI:1659482990
Name:MOBILITY PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:MOBILITY PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:BRIANT
Authorized Official - Last Name:SCHATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:949-540-0301
Mailing Address - Street 1:38 SHAMAN
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-8810
Mailing Address - Country:US
Mailing Address - Phone:949-540-0301
Mailing Address - Fax:949-540-0334
Practice Address - Street 1:24551 RAYMOND WAY STE 125
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4478
Practice Address - Country:US
Practice Address - Phone:949-540-0301
Practice Address - Fax:949-540-0334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 25356261QP2000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NOTAVAILABLEOtherN/A
CAW15987Medicare ID - Type UnspecifiedGROUP ID
CAWPT25356AMedicare ID - Type UnspecifiedPPIN