Look up the most recent NPI and PECOS records

Mksdpt Inc

(<Unavail>)

Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

8500 Wilshire Blvd, Beverly Hills, CA 90211-3121

(310) 659-3389 (949) 933-9630

PECOS Enrollment

Based on the most recent information from CMS, provider Mksdpt Inc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1689119232
Provider Type
Organization
Full Name
Mksdpt Inc
Other Name
<Unavail>

Subpart
No
Enumeration Date
1/5/2017
Last Updated
1/5/2017

Contact Information

Practice Location

8500 Wilshire Blvd, Beverly Hills, CA 90211-3121

(310) 659-3389

Unlisted Fax

Mailing Location

654 W Wilson St, Costa Mesa, CA 92627-2469

(949) 933-9630

Unlisted Fax

Authorized Official

Szkalak, Matthew (Owner)

(949) 933-9630

Provider Taxonomies

Code	Description	License
Code 225100000X Primary	Description Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License PT36431 California

Mksdpt Inc

(<Unavail>)

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Jorgensen, Alexander

Tan, Heide Jean Ramirez

Ramirez, Lujaye

Monte, William David

Soleimani, Kevin

Higgins, Matthew

Uglov, Yuliy

Sky Sport Spa

Joint Effort Medical Wellness

Miranda, Sean