# VICTORY PHYSICAL REHABILITATION, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033803168
- **Authorized official:** DR. MICHAEL MEYER KOSHAK MD (PRESIDENT)
- **Authorized official phone:** (818) 419-0049

## Contact information

- **Practice address:** 11631 VICTORY BLVD STE 101B, NORTH HOLLYWOOD, CA 91606-3572
- **Practice address phone:** (323) 645-1871
- **Practice address fax:** (818) 764-3032
- **Mailing address:** 11631 VICTORY BLVD STE 101B, NORTH HOLLYWOOD, CA 91606-3572
- **Mailing address phone:** (323) 645-1871
- **Mailing address fax:** (818) 764-3032

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/02/2023
- **Last updated:** 06/02/2023