Provider Demographics
NPI:1528747482
Name:PROJECT PERFORMANCE PHYSICAL THERAPY, APC
Entity type:Organization
Organization Name:PROJECT PERFORMANCE PHYSICAL THERAPY, APC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCUAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:818-480-2283
Mailing Address - Street 1:4901 MORENA BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-7313
Mailing Address - Country:US
Mailing Address - Phone:818-480-2283
Mailing Address - Fax:
Practice Address - Street 1:4901 MORENA BLVD STE 501
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-7313
Practice Address - Country:US
Practice Address - Phone:818-480-2283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy