Provider Demographics
NPI:1902297260
Name:OK PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:OK PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SU
Authorized Official - Middle Name:HEE
Authorized Official - Last Name:WHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-480-0021
Mailing Address - Street 1:520 S VIRGIL AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1425
Mailing Address - Country:US
Mailing Address - Phone:213-480-0021
Mailing Address - Fax:213-480-0029
Practice Address - Street 1:520 S VIRGIL AVE STE 207
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1425
Practice Address - Country:US
Practice Address - Phone:213-480-0021
Practice Address - Fax:213-480-0029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225200000X, 225X00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty