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General NPI Number Information
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NPI Number | 1780806182
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Entity Type | Organization
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Legal Business Name | J S REHABILITATION AND DC, INC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 304 N KENMORE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90004-3316
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Country | US
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Telephone | 323-662-8381
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Fax |
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Provider Business Mailing Address
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Address Line | 3114 HENRIETTA AVE
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City | LA CRESCENTA
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State | CA
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Zip | 91214-1913
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Country | US
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Telephone | 818-541-0833
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JUNGSIK JIN
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Credential | RPT
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Telephone | 818-541-0833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT17006
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT8004
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License Number State | CA
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