NPIMap

Organization Active NPI

Southland Physical Therapy, Inc.

  • Physical Therapist
  • Irvine, CA
National Provider Identifier
1710150172
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SOUTHLAND PHYSICAL THERAPY, INC.
Practice address
4482 Barranca Pkwy Ste 195
Irvine, CA 92604-4706
Phone
(949) 679-3337
Fax
(949) 679-3336
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Authorized official

Name
Jason Hyuk Park, DPTNPI 1053370239
Title
Ceo
Phone
(949) 679-3337

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
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

4482 Barranca Pkwy Ste 195
Irvine, CA 92604-4706

Mailing address

4482 Barranca Pkwy Ste 195
Irvine, CA 92604-4706
Phone (949) 679-3337

Other practice location 1

801 N Tustin Ave Ste 407
Santa Ana, CA 92705-3608
Phone (714) 862-2123

Other practice location 2

12362 Beach Blvd Ste 16
Stanton, CA 90680-3955
Phone (714) 410-8477

Other practice location 3

2170 N Bellflower Blvd
Long Beach, CA 90815-3126
Phone (562) 384-4525

Other practice location 4

2755 Bristol St Ste 130
Costa Mesa, CA 92626-5985
Phone (714) 966-2950

Other names 1

  • Excel Physical Therapy Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081028000046 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9234297771 Receives reassigned benefits from 33 practitioners
Practice locations: Costa Mesa, CA; Irvine, CA; Long Beach, CA; Mission Viejo, CA; Santa Ana, CA; Stanton, CA

National Provider Directory

National Provider Directory

Locations

2744 Bristol St
Ste 130
Costa Mesa, CA 92626

4482 Barranca Pkwy
Ste 195
Irvine, CA 92604
Phone (949) 679-3337

2820 N Bellflower Blvd
Long Beach, CA 90815
Phone (562) 384-4525

2170 N Bellflower Blvd
Long Beach, CA 90815
Phone (562) 384-4525

801 N Tustin Ave
Ste 407
Santa Ana, CA 92705
Phone (714) 565-0702

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787270400000",
    "number": "1710150172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4482 BARRANCA PKWY STE 195",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044706",
            "telephone_number": "949-679-3337",
            "fax_number": "949-679-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4482 BARRANCA PKWY STE 195",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044706",
            "telephone_number": "949-679-3337",
            "fax_number": "949-679-3336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 N Tustin Ave Ste 407",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927053608",
            "country_code": "US",
            "telephone_number": "714-862-2123",
            "fax_number": "714-862-2124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12362 Beach Blvd Ste 16",
            "address_purpose": "LOCATION",
            "city": "Stanton",
            "state": "CA",
            "postal_code": "906803955",
            "country_code": "US",
            "telephone_number": "714-410-8477",
            "fax_number": "714-410-8478",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2170 N Bellflower Blvd",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908153126",
            "country_code": "US",
            "telephone_number": "562-384-4525",
            "fax_number": "562-384-4524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2755 Bristol St Ste 130",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926265985",
            "country_code": "US",
            "telephone_number": "714-966-2950",
            "fax_number": "714-557-2487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHLAND PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "HYUK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-679-3337",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Physical Therapy Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Excel Physical Therapy Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.