Provider Demographics
NPI:1053585950
Name:M & M PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:M & M PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SPENCER
Authorized Official - Last Name:MONNAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:949-218-0790
Mailing Address - Street 1:800 CORPORATE DR
Mailing Address - Street 2:SUITE190
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-1152
Mailing Address - Country:US
Mailing Address - Phone:949-218-0790
Mailing Address - Fax:949-218-0791
Practice Address - Street 1:800 CORPORATE DR
Practice Address - Street 2:SUITE190
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-1152
Practice Address - Country:US
Practice Address - Phone:949-218-0790
Practice Address - Fax:949-218-0791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT16943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty