Provider Demographics
NPI:1215649520
Name:PEAK PHYSICAL PERFORMANCE PHYSICAL THERAPY CORP
Entity type:Organization
Organization Name:PEAK PHYSICAL PERFORMANCE PHYSICAL THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FOUST
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:949-791-7321
Mailing Address - Street 1:270 BRISTOL ST STE 101-101
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:270 BRISTOL ST STE 101-101
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5936
Practice Address - Country:US
Practice Address - Phone:949-791-7321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy