PROEDGE PHYSICAL THERAPY (NPI# 1609004480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609004480 |
| Entity Type | Organization |
| Organization Name | PROEDGE PHYSICAL THERAPY |
| Practice Address |
1124 Main St Suite C Irvine CA 92614-6760 |
| Mailing Address |
P.o. Box 13144 Newport Beach CA 92658-5086 |
| Practice Telephone | 9496797755 |
| Practice Fax Number | 9496797755 |
| Mailing Telephone | 9496797755 |
| Mailing Fax Number | 9496797755 |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2009-06-30 |
| Authorized Official Name | SARA SOGOL AMOLI (OWNER) |
| Authorized Official Telephone | 9496797755 |
| Authorized Official Credential | MPT, C.S.C.S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
26792 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1124 MAIN ST SUITE C |
| City | IRVINE |
| State | CA |
| Zip Code | 92614-6760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073622734 | Rheena Nieto Burkhardt | Physical Therapist | 1124 Main St, Suite C, Irvine, CA 92614-6760 | 2006-08-29 |
| 1548416829 | Well Balanced Body Inc | Clinic/Center | 1124 Main St, Suite C, Irvine, CA 92614-6760 | 2008-08-18 |
| 1306934856 | Sara Sogol Amoli | Physical Therapist | 1124 Main St, Suite C, Irvine, CA 92614-6760 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396352944 | Irvine Surgical Center LLC | Clinic/Center | 17624 Redhill Ave Ste B, Irvine, CA 92614 | 2020-09-28 |
| 1245843572 | Jose Raul Sanchez IIi | Behavior Technician | 1063 Mcgraw Ave, Irvine, CA 92614 | 2020-08-26 |
| 1548871064 | Angelina Renee Armenta | Behavior Technician | 1063 Mcgraw Avenue, Suite 100, Irvine, CA 92614 | 2020-08-10 |
| 1083267827 | Jd Health LLC | Durable Medical Equipment & Medical Supplies | 18003 Sky Park Circle, Suite B-c, Irvine, CA 92614 | 2019-07-22 |
| 1326609280 | Abigail Briana Lozano-flores | Behavior Technician | 18008 Sky Park Circle, Suite 110, Irvine, CA 92614 | 2019-06-21 |
| 1770085235 | Heather M. Ayala | Dietitian, Registered | 17985 Sky Park Circle Suite A, Irvine, CA 92614 | 2018-03-01 |
| 1598266033 | Camille Plumbar | Chiropractor | 17811 Skypark Circle, Suite E, Irvine, CA 92614 | 2018-02-21 |
| 1952812448 | Mary M Ahmadian | Nurse Practitioner | Global Transitional Care Suite 100, 2 Executive Circle, Irvine, CA 92614 | 2017-10-24 |
| 1134656804 | Reza Abaei Tafreshi | Dentist | 3 Pazzi, Irvine, CA 92614 | 2017-05-12 |
| 1467991307 | Laboratory Medicine Consultants In Diagnostics | Medical Genetics | 1565 A Mcgaw Ave, Irvine, CA 92614 | 2017-02-13 |
| Find all providers in zip 92614 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184040289 | David Hug | Physical Therapist | 142 Trellis Ln, Irvine, CA 92620-0214 | 2014-03-13 |
| 1760522551 | Julie Holt | Physical Therapist | 17232 Red Hill Ave, Irvine, CA 92614-5628 | 2007-02-08 |
| 1083790778 | Gregory K. Saito | Physical Therapist | 4330 Barranca Pkwy Ste 240, Irvine, CA 92604-4768 | 2006-10-27 |
| 1841837846 | Brian Scott Banh | Physical Therapist | 15775 Laguna Canyon Rd Ste 110, Irvine, CA 92618-3192 | 2019-12-09 |
| 1104472752 | Bradley Physiotherapy PC | Physical Therapist | 19732 Macarthur Blvd Ste 125, Irvine, CA 92612-2455 | 2019-08-09 |
| 1255832259 | Alvin Yeh | Physical Therapist | 17332 Von Karman Ave Ste 120, Irvine, CA 92614-6282 | 2018-02-24 |
| 1366966137 | Torey James Perez | Physical Therapist | 1 Peters Canyon Rd Ste 120, Irvine, CA 92606-1748 | 2017-08-02 |
| 1538616206 | Vincent Libonati | Physical Therapist | 15785 Laguna Canyon Rd, Suite 110, Irvine, CA 92618-3165 | 2016-09-09 |
| 1790182947 | Sarah Frudakis | Physical Therapist | 6640 Alton Pkwy, Irvine, CA 92618 | 2014-12-02 |
| 1649537168 | Christine Ann Russo | Physical Therapist | 4870 Barranca Pkwy, #340, Irvine, CA 92604-4709 | 2012-04-22 |
| Find all providers in IRVINE | ||||
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| 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.