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

Individual provider Physical Therapist · NPI 1710902051

Elijah Jerae Bishop III, PTMPTOCS is a Physical Therapist in Private Practice in LA Quinta, California. Qualified in 2002, 24 years ago. Practices with Mdrs Spine and Sport Inc, a 182-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
24
Licensed in
CA
In the registry since
2006
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Practice location Address checks out

79440 Corporate Center Dr Ste 112
LA Quinta, CA 92253-7243
Phone: (760) 771-9054
Fax: (760) 771-9057
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 72780 Country Club Dr Ste C300, Rancho Mirage, CA 92270-4150 — (760) 636-5207

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT28284 (CA)

Record details

NPI number1710902051
Entity typeIndividual (Type 1)
GenderMale
Credentials PTMPTOCS
Sole proprietorNo
NPI enumeratedJuly 13, 2006
Last updated in NPPESMay 13, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Mdrs Spine And Sport Inc — 182 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in LA Quinta