Provider Demographics
NPI:1013613041
Name:ADVANCED HAND THERAPY AND REHABILITATION OC, INC.
Entity Type:Organization
Organization Name:ADVANCED HAND THERAPY AND REHABILITATION OC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DYJAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-241-5386
Mailing Address - Street 1:27601 FORBES RD STE 54
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1242
Mailing Address - Country:US
Mailing Address - Phone:949-414-2696
Mailing Address - Fax:949-806-3441
Practice Address - Street 1:27601 FORBES RD STE 54
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1242
Practice Address - Country:US
Practice Address - Phone:949-414-2696
Practice Address - Fax:949-806-3441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty