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Organization

VICTORY PHYSICAL REHABILITATION, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL MEYER KOSHAK MD (PRESIDENT)
(818) 419-0049
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary

Other

Enumeration date
06/02/2023
Last updated
06/02/2023
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