Provider Demographics
NPI:1295829299
Name:SOCAL PHYSICAL THERAPY ASSOCIATES INC.
Entity Type:Organization
Organization Name:SOCAL PHYSICAL THERAPY ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DILLON
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:626-905-7720
Mailing Address - Street 1:1489 E CHEVY CHASE DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4008
Mailing Address - Country:US
Mailing Address - Phone:818-409-9990
Mailing Address - Fax:818-409-9991
Practice Address - Street 1:1489 E CHEVY CHASE DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4008
Practice Address - Country:US
Practice Address - Phone:818-409-9990
Practice Address - Fax:818-409-9991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty