Oc Dynamic Rehab, Inc.

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

Legal business name

OC DYNAMIC REHAB, INC.

Practice address

2100 E Wilshire Ave Ste B
Santa Ana, CA 92705-4783

Phone

(714) 573-8585

Fax

(714) 544-2189

NPI assigned

Aug 3, 2010

Organization subpart

No

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

Authorized official

Name

John Michael Hubbard, PT

Title

Owner

Phone

(714) 573-8585

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280793600000",
    "number": "1467766238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E WILSHIRE AVE STE B",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054783",
            "telephone_number": "714-573-8585",
            "fax_number": "714-544-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E WILSHIRE AVE STE B",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054783",
            "telephone_number": "714-573-8585",
            "fax_number": "714-544-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OC DYNAMIC REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-03",
        "last_updated": "2010-08-03",
        "status": "A",
        "authorized_official_last_name": "HUBBARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-573-8585",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ61648Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sports Physical Therapist in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Sports Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.