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22821 Lake Forest Dr Ste 115, Lake Forest, CA 92630 | |
| (949) 716-5050 | |
| (949) 482-2122 |
| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 22821 Lake Forest Dr Ste 115, Lake Forest, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588985832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT29776 (California) | Primary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Secondary |
| Provider Name | Cary Costa |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952690901 PECOS PAC ID: 7315123577 Enrollment ID: I20110524000335 |
| Provider Name | Dennis H Nguyen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336619022 PECOS PAC ID: 8527305705 Enrollment ID: I20190125001164 |
| Provider Name | Tanner Bennett Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104471523 PECOS PAC ID: 9234468281 Enrollment ID: I20190917001522 |
| Provider Name | Justine Dale Montero Cabanting |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548901309 PECOS PAC ID: 4082094123 Enrollment ID: I20220706003250 |
| Provider Name | Whitney Plaster |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487375150 PECOS PAC ID: 1658757992 Enrollment ID: I20221010002691 |
| Provider Name | Duc Cong Tran |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154179570 PECOS PAC ID: 4284168337 Enrollment ID: I20241112001479 |
| Mailing Address | Practice Location Address |
|---|---|
22821 Lake Forest Dr Ste 115, Lake Forest, CA 92630-1606 Ph: (949) 716-5050 | 22821 Lake Forest Dr Ste 115, Lake Forest, CA 92630 Ph: (949) 716-5050 |
Ryan Michael Somers, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 22772 Centre Dr Ste 100, Lake Forest, CA 92630 Phone: 949-955-9499 | |
Mark Eugene Wegener, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 23832 Rockfield Blvd Ste 160, Lake Forest, CA 92630 Phone: 949-465-9500 Fax: 949-465-9506 | |
Brian Gunzelman, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 24301 Muirlands Blvd, Suite T, Lake Forest, CA 92630 Phone: 949-271-0012 Fax: 949-271-0013 | |
Jacqueline Sue Maroun, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 24551 Raymond Way, #265, Lake Forest, CA 92630 Phone: 949-305-8200 Fax: 949-305-2211 | |
Christina Hui-i Yu, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 24301 Muirlands Blvd., Suite T, Lake Forest, CA 92630 Phone: 949-271-0012 Fax: 949-271-0013 | |
Michele Blanscet, P.T.A. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 25172 Pizarro Rd, Lake Forest, CA 92630 Phone: 949-951-2770 Fax: 949-951-2976 | |