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Organization
TRANSFORMATIVE PHYSICAL REHAB LLC
Active
Organization
TRANSFORMATIVE PHYSICAL REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATRIN MUTIANY IZUMI OTR/L (OCCUPATIONAL THERAPIST/OWNER)
(626) 297-0658
Entity
Organization
Contact information
Practice address
230 S ALTADENA DR, PASADENA, CA 91107-4820
(626) 297-0658
Mailing address
1909 CONDON AVE, REDONDO BEACH, CA 90278-3402
(626) 297-0658
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
04/22/2020
Last updated
05/02/2023
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