Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Costa Rehab and Wellness Clinic

Organization Physical Therapist · NPI 1730588575

Costa Rehab and Wellness Clinic provides Physical Therapist services in Lake Forest, California. Licensed in California. Registered with an NPI since 2014.

Licensed in
CA
In the registry since
2014
Specialties on file
9
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Practice location Address checks out

22821 Lake Forest Dr Ste 115
Lake Forest, CA 92630-1606 Not confirmed with CMS for 10 years — call before visiting
Phone: (949) 716-5050
Fax: (949) 482-2122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopedic Physical Therapist (primary) Taxonomy 2251X0800X · Licence PT37671 (CA)
Physical Therapist Taxonomy 225100000X · Licence PT37671 (CA)
Cardiopulmonary Physical Therapist Taxonomy 2251C2600X · Licence PT37671 (CA)
Ergonomics Physical Therapist Taxonomy 2251E1200X · Licence PT37671 (CA)
Geriatric Physical Therapist Taxonomy 2251G0304X · Licence PT37671 (CA)
Hand Physical Therapist Taxonomy 2251H1200X · Licence PT37671 (CA)
Neurology Physical Therapist Taxonomy 2251N0400X · Licence PT37671 (CA)
Pediatric Physical Therapist Taxonomy 2251P0200X · Licence PT37671 (CA)
Sports Physical Therapist Taxonomy 2251S0007X · Licence PT37671 (CA)

Record details

NPI number1730588575
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cary Costa — Ceo · (971) 998-4484
NPI enumeratedAugust 18, 2014
Last updated in NPPESApril 14, 2016
Mailing address22821 Lake Forest Dr, Suite 115, Lake Forest, CA 92630-1606

Other providers in Lake Forest