Provider Demographics
NPI:1881727337
Name:LUNDY, JAMES (RPT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:LUNDY
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N AVIATION BLVD
Mailing Address - Street 2:UNIT B
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-7015
Mailing Address - Country:US
Mailing Address - Phone:310-376-9200
Mailing Address - Fax:
Practice Address - Street 1:210 N AVIATION BLVD
Practice Address - Street 2:UNIT B
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-7015
Practice Address - Country:US
Practice Address - Phone:310-376-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25268225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist