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General NPI Number Information
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NPI Number | 1518459346
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Entity Type | Organization
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Legal Business Name | JASON FERINE PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 06/06/2018
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Last Update Date | 06/06/2018
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Provider Practice Location Address
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Address Line | 2300 WESTWOOD BLVD STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90064-2045
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Country | US
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Telephone | 424-365-2083
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Fax | 310-943-3532
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Provider Business Mailing Address
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Address Line | 1320 S BEVERLY GLEN BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90024-5206
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Country | US
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Telephone | 424-365-2083
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Fax | 310-943-3532
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JASON JOHN FERINE
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Credential | MSPT
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Telephone | 424-365-2083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT35755
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License Number State | CA
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