Provider Demographics
NPI:1780879437
Name:PEGASUS PHYSICAL THERAPY SOLUTIONS, INC.
Entity type:Organization
Organization Name:PEGASUS PHYSICAL THERAPY SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:JIA
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:949-206-9501
Mailing Address - Street 1:23521 PASEO DE VALENCIA
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3107
Mailing Address - Country:US
Mailing Address - Phone:949-206-9501
Mailing Address - Fax:949-382-1441
Practice Address - Street 1:23521 PASEO DE VALENCIA
Practice Address - Street 2:SUITE 303
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3107
Practice Address - Country:US
Practice Address - Phone:949-206-9501
Practice Address - Fax:949-382-1441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24069261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy