Healthcare Provider Details

I. General information

NPI: 1497400576
Provider Name (Legal Business Name): MOBILIZE PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E LIVE OAK AVE STE 200
ARCADIA CA
91006-5272
US

IV. Provider business mailing address

115 E LIVE OAK AVE STE 200
ARCADIA CA
91006-5272
US

V. Phone/Fax

Practice location:
  • Phone: 213-300-1089
  • Fax:
Mailing address:
  • Phone: 213-300-1089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHIA H YANG
Title or Position: OWNER
Credential: PT
Phone: 213-300-1089