Provider Demographics
NPI:1700215316
Name:OPTIMUM CARE PHYSICAL THERAPY SERVICES
Entity Type:Organization
Organization Name:OPTIMUM CARE PHYSICAL THERAPY SERVICES
Other - Org Name:OPTIMUM CARE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:B
Authorized Official - Last Name:SIMSUANGCO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:562-865-2222
Mailing Address - Street 1:17906 PIONEER BLVD
Mailing Address - Street 2:SUITE 101 - 102
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-2633
Mailing Address - Country:US
Mailing Address - Phone:562-865-2222
Mailing Address - Fax:888-423-0080
Practice Address - Street 1:17906 PIONEER BLVD
Practice Address - Street 2:SUITE 101 - 102
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-9070
Practice Address - Country:US
Practice Address - Phone:562-865-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28304261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy