Provider Demographics
NPI:1154407708
Name:KAI PHYSICAL THERAPY AND REHABILITATION, INC,
Entity type:Organization
Organization Name:KAI PHYSICAL THERAPY AND REHABILITATION, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO/CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS, CSCS
Authorized Official - Phone:949-838-6484
Mailing Address - Street 1:14252 CULVER DR STE A-437
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-0317
Mailing Address - Country:US
Mailing Address - Phone:949-743-5788
Mailing Address - Fax:
Practice Address - Street 1:18102 SKY PARK CIR STE J
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6531
Practice Address - Country:US
Practice Address - Phone:949-743-5788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty