Organization Active NPI

Back2 Health Physical Therapy Inc

  • Physical Medicine & Rehabilitation Physician
  • Los Angeles, CA
National Provider Identifier
1053419408
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PT32430 Issued in CA
Legal business name
BACK2 HEALTH PHYSICAL THERAPY INC
Practice address
1335 N la Brea Ave Ste 3
Los Angeles, CA 90028-7565
Phone
(310) 246-1050
NPI assigned
Sep 20, 2006
Last updated
Nov 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vladislav Shut, P.T.NPI 1578501052
Title
President
Phone
(310) 246-1050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT32430 CA Primary

Addresses

Primary practice location

1335 N la Brea Ave Ste 3
Los Angeles, CA 90028-7565

Mailing address

1335 N la Brea Ave
Los Angeles, CA 90028-7526
Phone (310) 246-1050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070103000306 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8527068246 Receives reassigned benefits from 19 practitioners
Practice locations: Encino, CA; Los Angeles, CA; Burbank, CA

National Provider Directory

National Provider Directory

Locations

930 W Alameda Ave
Burbank, CA 91506
Phone (818) 588-3880

17227 Ventura Blvd
Encino, CA 91316
Phone (818) 990-9930

3699 Wilshire Blvd
Ste 526
Los Angeles, CA 90010
Phone (213) 674-8852

1125 E 17th St
Ste E101103
Santa Ana, CA 92701
Phone (714) 543-3500

9201 W Sunset Blvd
Ste M120
West Hollywood, CA 90069
Phone (310) 246-1050

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1053419408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 N LA BREA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287526",
            "telephone_number": "310-246-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 N LA BREA AVE STE 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287565",
            "telephone_number": "310-246-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK2 HEALTH PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "SHUT",
        "authorized_official_first_name": "VLADISLAV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-246-1050",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT32430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.