Revitalize Rehab Club

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

30340 Issued in CA

Legal business name

REVITALIZE REHAB CLUB

Practice address

3646 Long Beach Blvd Ste 106
Long Beach, CA 90807-6025

Phone

(562) 548-0876

NPI assigned

Oct 2, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Danh Ngo, PT DPT OCS SCSNPI 1053628735

Title

Owner, Physical Therapist

Phone

(562) 548-0876

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Danh Ngo, PT, DPT, OCS, SCS

  • Orthopedic Physical Therapist
  • Long Beach, CA
  • NPI 1053628735

  Multi-Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506902400000",
    "number": "1346750601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3646 LONG BEACH BLVD STE 106",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908076025",
            "telephone_number": "562-548-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3646 LONG BEACH BLVD STE 106",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908076025",
            "telephone_number": "562-548-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE REHAB CLUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A",
        "authorized_official_last_name": "NGO",
        "authorized_official_first_name": "DANH",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "562-548-0876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT DPT OCS SCS"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "30340",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "30340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Retirement Housing Foundation
• Veronica Florez Reveles-Godinez, LMFT
• Diana Reveles
• Felicia Revero
• Revitalize Life Center a PC
• Revolving Door Resolution Center
• Desiree Rew, LCSW
• Georgia Marie Rew
• Rex J. Winters,MD ;Inc
• Adoracion Abaco Reyes, MD

• Orthopedic Physical Therapist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.