South Pacific Rehabilitation Services, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SOUTH PACIFIC REHABILITATION SERVICES, INC

Practice address

830 South Citrus Ave, Suite 203
Azusa, CA 91702-5911

Phone

(626) 339-6514

Fax

(626) 339-6573

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Calvin Iyoya

Title

Chief Operation Officer

Phone

(818) 986-1977

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1669572707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16260 VENTURA BLVD STE 600",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364604",
            "telephone_number": "818-986-1977",
            "fax_number": "818-986-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 SOUTH CITRUS AVE, SUITE 203",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917025911",
            "telephone_number": "626-339-6514",
            "fax_number": "626-339-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PACIFIC REHABILITATION SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "IYOYA",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_title_or_position": "CHIEF OPERATION OFFICER",
        "authorized_official_telephone_number": "818-986-1977",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Azusa, CA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.