Provider Demographics
NPI:1720806417
Name:DYNAMIK REHAB INC
Entity type:Organization
Organization Name:DYNAMIK REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:D
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:475-714-4501
Mailing Address - Street 1:14221 EUCLID ST STE F
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4991
Mailing Address - Country:US
Mailing Address - Phone:714-891-2747
Mailing Address - Fax:714-891-2747
Practice Address - Street 1:14221 EUCLID ST STE F
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4991
Practice Address - Country:US
Practice Address - Phone:714-891-2747
Practice Address - Fax:714-891-2747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty