Basic Information
| Provider Information | |||||||||
| NPI: | 1962404988 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TORTI | ||||||||
| FirstName: | CHRISTIE | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | P.T. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KILGORE | ||||||||
| OtherFirstName: | CHRISTINE | ||||||||
| OtherMiddleName: | A | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | P.T. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 200 NEWPORT CENTER DR | ||||||||
| Address2: | #213 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926607501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9496441322 | ||||||||
| FaxNumber: | 9496440316 | ||||||||
| Practice Location | |||||||||
| Address1: | 2888 LONG BEACH BLVD | ||||||||
| Address2: | #405 | ||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908061530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625954489 | ||||||||
| FaxNumber: | 5625954063 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 06/04/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT25612 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.