NPIMap

Organization Active NPI

Rehab and Revive Physical Therapy Inc.

  • Orthopedic Physical Therapist
  • Tustin, CA
National Provider Identifier
1528476165
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
35795 Issued in CA
Legal business name
REHAB AND REVIVE PHYSICAL THERAPY INC.
Practice address
14661 Myford Rd
Suite C
Tustin, CA 92780-7205
Phone
(714) 900-3880
Fax
(714) 731-0932
NPI assigned
Jul 28, 2014
Last updated
Nov 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Authorized official

Name
Dr. Justin Lin, DPTNPI 1063608891
Title
President and Director
Phone
(714) 900-3880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 35795 CA Primary

Addresses

Primary practice location

14661 Myford Rd
Suite C
Tustin, CA 92780-7205

Mailing address

14661 Myford Rd
Suite C
Tustin, CA 92780-7205
Phone (714) 900-3880

National Provider Directory

National Provider Directory

Locations

14661 Myford Rd
Ste C
Tustin, CA 92780
Phone (714) 900-3880

Practitioners & affiliated clinicians

Practitioners 3

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": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447113600000",
    "number": "1528476165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14661 MYFORD RD",
            "address_2": "SUITE C",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807205",
            "telephone_number": "714-900-3880",
            "fax_number": "714-731-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14661 MYFORD RD",
            "address_2": "SUITE C",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807205",
            "telephone_number": "714-900-3880",
            "fax_number": "714-731-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB AND REVIVE PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-28",
        "last_updated": "2015-11-10",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT AND DIRECTOR",
        "authorized_official_telephone_number": "714-900-3880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "35795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.