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

Michael P Bantolo, PT

Individual provider Physical Therapist · NPI 1558486084

Michael P Bantolo, PT is a Physical Therapist in Private Practice in LA Habra, California. Qualified in 1999, 27 years ago. Practices with California Luna Care Physical Therapy PC, a 773-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
27
Licensed in
CA
In the registry since
2007
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

See every abbreviation used in this directory →

Practice location Address checks out

1400 S Harbor Blvd Ste B
LA Habra, CA 90631-7577
Phone: (714) 441-0763
Fax: (714) 441-0883
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 26696 (CA)

Record details

NPI number1558486084
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedMarch 21, 2007
Last updated in NPPESDecember 6, 2021
Mailing address200 Newport Center Dr, 213, Newport Beach, CA 92660-7501

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice California Luna Care Physical Therapy Pc — 773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in LA Habra