Healthcare Provider Details

I. General information

NPI: 1023431046
Provider Name (Legal Business Name): POSITIVE PHYSICAL THERAPY AND FITNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11900 W OLYMPIC BLVD STE 101
LOS ANGELES CA
90064-1166
US

IV. Provider business mailing address

11900 W OLYMPIC BLVD STE 101
LOS ANGELES CA
90064-1166
US

V. Phone/Fax

Practice location:
  • Phone: 310-770-7586
  • Fax: 310-826-4517
Mailing address:
  • Phone: 310-770-7586
  • Fax: 310-824-5176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT 39223
License Number StateCA

VIII. Authorized Official

Name: DR. JASON WHITMAN
Title or Position: OWNER
Credential: PT
Phone: 323-719-1758