NPIMap

Organization Active NPI

Sports Rehab la

  • Physical Therapy Clinic/Center
  • Encino, CA
National Provider Identifier
1811423189
Registry record updated Aug 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SPORTS REHAB LA
Practice address
16200 Ventura Blvd
#201
Encino, CA 91436-2205
Phone
(818) 986-1203
Fax
(951) 272-9924
NPI assigned
May 5, 2017
Last updated
Aug 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2017

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

Authorized official

Name
Patrick Khaziran, D.C.NPI 1144463068
Title
President
Phone
(818) 986-1203

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary
Nutrition Chiropractor 111NN1001X CA
Radiology Chiropractor 111NR0200X CA
Sports Physician Chiropractor 111NS0005X CA
Acupuncturist 171100000X CA
Rehabilitation Chiropractor 111NR0400X CA

Addresses

Primary practice location

16200 Ventura Blvd
#201
Encino, CA 91436-2205

Mailing address

16200 Ventura Blvd
#201
Encino, CA 91436-2205
Phone (818) 986-1203

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1493942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502409600000",
    "number": "1811423189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16200 VENTURA BLVD",
            "address_2": "#201",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362205",
            "telephone_number": "818-986-1203",
            "fax_number": "951-272-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16200 VENTURA BLVD",
            "address_2": "#201",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362205",
            "telephone_number": "818-986-1203",
            "fax_number": "951-272-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS REHAB LA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-05",
        "last_updated": "2017-08-11",
        "status": "A",
        "authorized_official_last_name": "KHAZIRAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-986-1203",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.