Healthcare Provider Details

I. General information

NPI: 1851486237
Provider Name (Legal Business Name): OHANA PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13341 GARDEN GROVE BLVD. SUITE B
GARDEN GROVE CA
92843
US

IV. Provider business mailing address

13341 GARDEN GROVE BLVD. SUITE B
GARDEN GROVE CA
92843
US

V. Phone/Fax

Practice location:
  • Phone: 714-750-4097
  • Fax: 714-750-4616
Mailing address:
  • Phone: 714-750-4097
  • Fax: 714-750-4616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. DERRICK GEORGE SUEKI
Title or Position: OWNER
Credential: DPT
Phone: 714-750-4097