Organization Active NPI

Equip Physical Therapy and Rehabilitation Inc

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1831625839
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
292473 Issued in CA
Legal business name
EQUIP PHYSICAL THERAPY AND REHABILITATION INC
Practice address
505 S Virgil Ave Ste 204a
Los Angeles, CA 90020-1443
Phone
(213) 674-7699
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Authorized official

Name
Michael KangNPI 1265977896
Title
DPT
Phone
(213) 249-1150

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 292473 CA Primary

Addresses

Primary practice location

505 S Virgil Ave Ste 204a
Los Angeles, CA 90020-1443

Mailing address

505 S Virgil Ave Ste 204a
Los Angeles, CA 90020-1443
Phone (213) 674-7699

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170925001804 CA Part B Supplier - Clinic/Group Practice 5698049914 Receives reassigned benefits from 3 practitioners
Practice locations: Fullerton, CA; Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

642 W Commonwealth Ave
Fullerton, CA 92832
Phone (213) 674-7699

505 S Virgil Ave
Ste 204A
Los Angeles, CA 90020
Phone (213) 674-7699

3544 W Olympic Blvd
#102
Los Angeles, CA 90019
Phone (213) 674-7699

4017 W Olympic Blvd
Los Angeles, CA 90019
Phone (323) 424-7333

3544 W Olympic Blvd
Ste 102
Los Angeles, CA 90019

3544 W Olympic Blvd
Unit 102
Los Angeles, CA 90019

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1831625839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE STE 204A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201443",
            "telephone_number": "213-674-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE STE 204A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201443",
            "telephone_number": "213-674-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUIP PHYSICAL THERAPY AND REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DPT",
        "authorized_official_telephone_number": "213-249-1150"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.