Healthcare Provider Details

I. General information

NPI: 1609862606
Provider Name (Legal Business Name): LOTUS PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2005
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11710 WILSHIRE BLVD
LOS ANGELES CA
90025-1503
US

IV. Provider business mailing address

PO BOX 25595
LOS ANGELES CA
90025-0595
US

V. Phone/Fax

Practice location:
  • Phone: 310-494-1422
  • Fax: 310-496-0868
Mailing address:
  • Phone: 310-494-1422
  • Fax: 310-496-0868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT24989
License Number StateCA

VIII. Authorized Official

Name: ALMA GARCIA
Title or Position: OFFICE MANAGER
Credential:
Phone: 562-427-2225