Provider Demographics
NPI:1679598528
Name:NOSEK & ASSOCIATES PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:NOSEK & ASSOCIATES PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JOANN
Authorized Official - Last Name:NOSEK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:949-273-6766
Mailing Address - Street 1:26941 CABOT ROAD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-273-6766
Mailing Address - Fax:949-273-6765
Practice Address - Street 1:26941 CABOT ROAD
Practice Address - Street 2:SUITE 125
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-273-6766
Practice Address - Fax:949-273-6765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT23314225100000X
CAPT23144225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19732Medicare ID - Type Unspecified