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

Santa Monica Sports Medicine Inc

Organization Physical Medicine & Rehabilitation Physician · NPI 1205252673

Santa Monica Sports Medicine Inc is a Physical Medicine & Rehabilitation Physician in Santa Monica, California. Licensed in California. Registered with an NPI since 2014.

Licensed in
CA
In the registry since
2014
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

900 Wilshire Blvd #410
Santa Monica, CA 90401
Phone: (310) 458-1259
Fax: (310) 458-1395
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence A63662 (CA)

Record details

NPI number1205252673
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jorge Moran — President · (310) 458-1259
NPI enumeratedMarch 10, 2014
Last updated in NPPESMarch 10, 2014
Mailing address900 Wilshire Blvd Ste 410, Santa Monica, CA 90401-1886

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