Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Costa Rehab and Wellness Clinic

Organization Physical Therapist · NPI 1730588575

Costa Rehab and Wellness Clinic is a Physical Therapist 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
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