Organization · NPI-2

121 Rehab Physical Therapy Corp

Occupational Therapist · Pomona, CA

NPI number1962431049
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1962431049
Entity type
Organization (NPI-2)
Legal business name
121 Rehab Physical Therapy Corp
Organization subpart
No
Enumeration date
Jul 1, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist5319CAYes

Practice location

1940 N. Orange Grove Avenue Suite A
Pomona, CA 91767

Phone 909-620-8443

Mailing address

1940 N Orange Grove Ave Ste A
Pomona, CA 91767-3002

Authorized official

Armando Kim
President
9096208443

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