Provider Demographics
NPI:1881808178
Name:RAHN, JASON ALAN (MSPT)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:ALAN
Last Name:RAHN
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22735 MADISON ST
Mailing Address - Street 2:#6
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-2656
Mailing Address - Country:US
Mailing Address - Phone:310-791-1387
Mailing Address - Fax:
Practice Address - Street 1:22617 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2550
Practice Address - Country:US
Practice Address - Phone:310-320-4130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29931225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist