Provider Demographics
NPI:1386882447
Name:LAX REHABILITATION CENTER AND PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:LAX REHABILITATION CENTER AND PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-670-9999
Mailing Address - Street 1:9100 S SEPULVEDA BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-4849
Mailing Address - Country:US
Mailing Address - Phone:310-670-9999
Mailing Address - Fax:310-670-9994
Practice Address - Street 1:9100 S SEPULVEDA BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-4849
Practice Address - Country:US
Practice Address - Phone:310-670-9999
Practice Address - Fax:310-670-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty