NPIMap

Organization Active NPI

Comprehensive Therapeutic Rehabilitation Inc.

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1235266305
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT 11680 Issued in CA
Legal business name
COMPREHENSIVE THERAPEUTIC REHABILITATION INC.
Practice address
5301 Whittier Blvd
Los Angeles, CA 90022-4038
Phone
(323) 887-7458
Fax
(323) 887-8288
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Mario PolancoNPI 1073640587
Title
Physical Therapist
Phone
(310) 801-9550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X PT 11680 CA Primary

Addresses

Primary practice location

5301 Whittier Blvd
Los Angeles, CA 90022-4038

Mailing address

655 S Flower St
Los Angeles, CA 90017-2805
Phone (213) 430-9180

National Provider Directory

National Provider Directory

Locations

655 S Flower St
Los Angeles, CA 90017

5301 Whittier Blvd
Los Angeles, CA 90022
Phone (213) 430-9180

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235266305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S FLOWER ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900172805",
            "telephone_number": "213-430-9180",
            "fax_number": "213-430-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900224038",
            "telephone_number": "323-887-7458",
            "fax_number": "323-887-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE THERAPEUTIC REHABILITATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POLANCO",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "310-801-9550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT 11680",
            "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 Aug 22, 2020; 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.