| Prosport Physical Therapy Professionals Inc | |
|
28924 S Western Ave, Suite 101, Rancho Palos Verdes, CA 90275-0885 | |
| (310) 548-0104 | |
| (310) 548-0559 |
| Full Name | Prosport Physical Therapy Professionals Inc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 28924 S Western Ave, Rancho Palos Verdes, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487648341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Alexandra L Gryder |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1023599669 PECOS PAC ID: 1850635004 Enrollment ID: I20181129001202 |
| Provider Name | Casey Edward Maguire |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467557348 PECOS PAC ID: 9335059427 Enrollment ID: I20200506000195 |
| Mailing Address | Practice Location Address |
|---|---|
| Prosport Physical Therapy Professionals Inc Po Box 14155, Orange, CA 92863-1555 Ph: (714) 450-4999 | Prosport Physical Therapy Professionals Inc 28924 S Western Ave, Suite 101, Rancho Palos Verdes, CA 90275-0885 Ph: (310) 548-0104 |
Jennifer Hill Ryan, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5801 Crestridge Rd, Rancho Palos Verdes, CA 90275 Phone: 877-582-0153 | |
Nicola Akiko Koyama, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4244 Stalwart Dr, Rancho Palos Verdes, CA 90275 Phone: 310-774-7626 | |
Mitsuo Yamauchi, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 30210 Cheret Pl, Rancho Palos Verdes, CA 90275 Phone: 310-634-9211 | |
Karen Ching, Physical Therapist Medicare: Medicare Enrolled Practice Location: 5024 Golden Arrow Dr, Rancho Palos Verdes, CA 90275 Phone: 310-541-7537 | |
Margarita Ruby Vargas, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 28924 S Western Ave, Rancho Palos Verdes, CA 90275 Phone: 310-548-0104 | |
Brad Thomas, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 28924 S Western Ave Ste 101, Rancho Palos Verdes, CA 90275 Phone: 310-548-0104 | |
Ms. Doris Angela Paloma, MS,PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1701 Byerton Ct, Rancho Palos Verdes, CA 90275 Phone: 310-402-9027 |