Healthcare Provider Details

I. General information

NPI: 1336349745
Provider Name (Legal Business Name): REHAB UNLIMITED, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 07/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3545 WILSHIRE BLVD STE 250
LOS ANGELES CA
90010-2389
US

IV. Provider business mailing address

3545 WILSHIRE BLVD STE 250
LOS ANGELES CA
90010-2389
US

V. Phone/Fax

Practice location:
  • Phone: 213-389-3334
  • Fax: 213-389-3353
Mailing address:
  • Phone: 213-389-3334
  • Fax: 213-389-3353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT26124
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6558
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14272
License Number StateCA

VIII. Authorized Official

Name: JOON PARK
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 213-389-3334