PROFORMANCE PHYSICAL THERAPY AND REHABILITATION, INC. (NPI# 1538166079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538166079 |
| Entity Type | Organization |
| Organization Name | PROFORMANCE PHYSICAL THERAPY AND REHABILITATION, INC. |
| Other Organization Name | PRO PHYSICAL THERAPY |
| Practice Address |
490 S San Vicente Blvd Ste 3 Los Angeles CA 90048-4132 |
| Mailing Address |
2309 Pacific Ave Manhattan Beach CA 90266-2631 |
| Practice Telephone | 3236559055 |
| Practice Fax Number | 3236559255 |
| Mailing Telephone | 3236974046 |
| Mailing Fax Number | 3236559255 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2020-08-26 |
| Authorized Official Name | MR. DONALD E NELSON JR. (PRESIDENT) |
| Authorized Official Telephone | 3236559055 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT21545 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| PRO Physical Therapy | Doing Business As Name - Organization |
| Street Address |
490 S SAN VICENTE BLVD STE 3 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90048-4132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1760090062 | New Dawn Tms Psychiatry | Clinic/Center | 640 S San Vincente Blvd, Ste. 210, Los Angeles, CA 90048 | 2020-07-22 |
| 1114547312 | Savannah Marie Gonzales | Student in an Organized Health Care Education/Training Program | 8700 Beverly Blvd Suite 3636, Los Angeles, CA 90048 | 2020-04-17 |
| 1861048613 | Sam Dawkins | Internal Medicine | Suite 415e, 8631 West Third Street, Los Angeles, CA 90048 | 2019-08-16 |
| 1295202638 | Caleb Rogers Penn | Anesthesiology | Cedars-sinai Department of Anesthesiology, 8700 Beverly Blvd, Los Angeles, CA 90048 | 2018-10-24 |
| 1437641727 | Medical Imaging Center of Southern California-beverly Hills, Inc | Radiology | 8727 Beverly Blvd, Los Angeles, CA 90048 | 2018-06-01 |
| 1689164121 | Maulin Shah | Student in an Organized Health Care Education/Training Program | 8700 Beverly Blvd Suite 5512, Los Angeles, CA 90048 | 2018-05-10 |
| 1013423631 | Abdul Ali Qaderi | Anesthesiology | 8700 Beverly Blvd Suite 4209, Los Angeles, CA 90048 | 2017-12-19 |
| 1619483559 | Sakeenah Hakim | Social Worker | 292 S. La Cienega Blvd, Suite 102, Los Angeles, CA 90048 | 2017-12-14 |
| 1851805048 | West Hollywood Medical Group Inc | General Practice | 8733 Beverly Blvd Suite #203, West Hollywood, CA 90048 | 2017-11-27 |
| Find all providers in zip 90048 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900789 | Sierra Speck | Physical Therapist | 11701 Wilshire Blvd Ste 14b1, Los Angeles, CA 90025-1547 | 2020-10-22 |
| 1992312086 | Heidi Lynne Anders | Physical Therapist | 5805 W 8th St Apt 205, Los Angeles, CA 90036-4576 | 2020-09-23 |
| 1376151126 | Yifu Zhou | Physical Therapist | 1625 W Olympic Blvd Ste 790, Los Angeles, CA 90015-3809 | 2020-07-17 |
| 1659921054 | Nazanin Amini | Physical Therapist | 5450 W Pico Blvd Ste 202, Los Angeles, CA 90019-3997 | 2019-09-17 |
| 1609393396 | Victory Performance and Physical Therapy | Physical Therapist | 11461 W Washington Blvd Ste 1, Los Angeles, CA 90066-6014 | 2017-08-24 |
| 1740728112 | Michael Karas | Physical Therapist | 3745 Bagley Ave, Apt. 202, Los Angeles, CA 90034-7404 | 2017-02-06 |
| 1851776694 | Reliable Emg | Physical Therapist | 3450 Sawtelle Blvd Apt 140, Los Angeles, CA 90066-2163 | 2015-07-22 |
| 1568866184 | Lauren Freitas | Physical Therapist | 10877 Wilshire Blvd, Ste P1, Los Angeles, CA 90024-4413 | 2014-10-09 |
| 1700127610 | Julianne Frances Kelman | Physical Therapist | 321 N. Larchmont Blvd. #825, Larchmont Physical Therapy, Los Angeles, CA 90004-6400 | 2013-03-04 |
| 1760741342 | Kenneth Taik Kim | Physical Therapist | 3301 S Hoover St, Los Angeles, CA 90007-3557 | 2012-05-16 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90048 |
Please comment or provide details below to improve the information on PROFORMANCE PHYSICAL THERAPY AND REHABILITATION, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.