Organization
LORI RUBENSTEIN PHYSICAL THERAPY, INC
Active
Other names
Mosaic Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
LORI R FAZZIO PT (DIRECTOR)
(310) 401-6410
Entity
Organization
Contact information
Practice address
11835 W OLYMPIC BLVD, SUITE 135E, LOS ANGELES, CA 90064-5001
(310) 401-6410
Mailing address
PO BOX 641428, LOS ANGELES, CA 90064-6428
(310) 401-6410
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT 14694
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT14694
PT LICENSE
CA
Enumeration date
11/10/2006
Last updated
10/05/2016
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