Provider Demographics
NPI:1770820177
Name:MOBILE SOLUTIONS PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:MOBILE SOLUTIONS PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:LUXENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CSCS
Authorized Official - Phone:949-683-1661
Mailing Address - Street 1:14 ORANGE BLOSSOM CIR
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-1250
Mailing Address - Country:US
Mailing Address - Phone:949-683-1661
Mailing Address - Fax:949-954-4206
Practice Address - Street 1:14 ORANGE BLOSSOM CIR
Practice Address - Street 2:
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-1250
Practice Address - Country:US
Practice Address - Phone:949-683-1661
Practice Address - Fax:949-954-4206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT38419225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty