Healthcare Provider Details

I. General information

NPI: 1851546337
Provider Name (Legal Business Name): WEST LOS ANGELES HAND THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2008
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11040 SANTA MONICA BLVD STE 207
LOS ANGELES CA
90025-7522
US

IV. Provider business mailing address

1785 BELOIT AVE APT 407
LOS ANGELES CA
90025-4280
US

V. Phone/Fax

Practice location:
  • Phone: 310-228-7020
  • Fax:
Mailing address:
  • Phone: 310-228-7020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number7637
License Number StateCA

VIII. Authorized Official

Name: YU-JU HUANG
Title or Position: CEO
Credential: OTR/L CHT
Phone: 310-228-7020