Maum Wellness Physical Therapy Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 41176 Issued in CA

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

Last updated

Mar 31, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin Lee, DPTNPI 1336567023

Title

Ceo

Phone

(845) 270-5771

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Justin Lee, DPT

  • Physical Therapist
  • Gardena, CA
  • NPI 1336567023
  Authorized official Same address or phone

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": []
}

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• Physical Therapist in Gardena, CA
• Providers in Gardena, CA by specialty
• Physical Therapist in California

• 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.

Verify at the official NPI Registry.