Healthcare Provider Details

I. General information

NPI: 1639296106
Provider Name (Legal Business Name): USC PHYSICAL THERAPY ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 12/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 MARENGO ST #102
LOS ANGELES CA
90033-1036
US

IV. Provider business mailing address

1640 MARENGO ST #102
LOS ANGELES CA
90033-1036
US

V. Phone/Fax

Practice location:
  • Phone: 323-865-1200
  • Fax: 323-865-1258
Mailing address:
  • Phone: 323-865-1200
  • Fax: 323-865-1258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: YOGI MATHARU
Title or Position: DIRECTOR OF PHYSICAL THERAPY SERVIC
Credential: DPT
Phone: 323-865-1200