Provider Demographics
NPI:1508807942
Name:JOSEPH S LUK PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:JOSEPH S LUK PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LUK
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:818-240-5012
Mailing Address - Street 1:435 ARDEN AVE STE 370
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1146
Mailing Address - Country:US
Mailing Address - Phone:818-240-5012
Mailing Address - Fax:818-240-8438
Practice Address - Street 1:435 ARDEN AVE STE 370
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1146
Practice Address - Country:US
Practice Address - Phone:818-240-5012
Practice Address - Fax:818-240-8438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT6698225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA056807Medicare Oscar/Certification
CAPT6698AMedicare ID - Type UnspecifiedNHIC