Active NPI
Maum Wellness Physical Therapy Inc
- Physical Therapist
- Gardena, CA
National Provider Identifier
1104244805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 41176
- Legal business name
- MAUM WELLNESS PHYSICAL THERAPY INC
- Practice address
- 1607 W Redondo Beach Blvd
Gardena, CA 90247-3241 - Phone
- (714) 590-3211
- Fax
- (714) 590-3210
- NPI assigned
- Mar 31, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Justin Lee, DPT
- Title
- Ceo
- Phone
- (845) 270-5771
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 41176 | CA | Primary |
Addresses
Primary practice location
1607 W Redondo Beach Blvd
Gardena, CA 90247-3241
Mailing address
1607 W Redondo Beach Blvd
Gardena, CA 90247-3241
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396224000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1396224000000",
"number": "1104244805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1607 W REDONDO BEACH BLVD",
"city": "GARDENA",
"state": "CA",
"postal_code": "902473241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1607 W REDONDO BEACH BLVD",
"city": "GARDENA",
"state": "CA",
"postal_code": "902473241",
"telephone_number": "714-590-3211",
"fax_number": "714-590-3210"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAUM WELLNESS PHYSICAL THERAPY INC",
"organizational_subpart": "NO",
"enumeration_date": "2014-03-31",
"last_updated": "2014-03-31",
"status": "A",
"authorized_official_last_name": "LEE",
"authorized_official_first_name": "JUSTIN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "845-270-5771",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 41176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.