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Organization
SOUTHLAND PHYSICAL THERAPY, INC.
Active
Organization
SOUTHLAND PHYSICAL THERAPY, INC.
Active
Other names
Excel Physical Therapy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JASON HYUK PARK DPT (CEO)
(949) 679-3337
Entity
Organization
Contact information
Practice address
4482 BARRANCA PKWY STE 195, IRVINE, CA 92604-4706
(949) 679-3337
(949) 679-3336
Mailing address
4482 BARRANCA PKWY STE 195, IRVINE, CA 92604-4706
(949) 679-3337
(949) 679-3336
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT24454
CA
225100000X
Physical Therapist
Primary
PT32067
CA
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT320670
BLUE SHIELD PIN
CA
01
—
OPT244540
BLUE SHIELD PIN
CA
01
—
OPT370670
BLUE SHIELD PIN
—
01
—
OPT384920
BLUE SHIELD PIN (RACHEL LEE, DPT)
CA
01
—
OT0015030
BLUE SHIELD PIN (SHERYL LEE, OTL)
CA
Enumeration date
04/08/2008
Last updated
08/21/2026
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