Organization
OC DYNAMIC REHAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MICHAEL HUBBARD PT (OWNER)
(714) 573-8585
Entity
Organization
Contact information
Practice address
2100 E WILSHIRE AVE STE B, SANTA ANA, CA 92705-4783
(714) 573-8585
(714) 544-2189
Mailing address
2100 E WILSHIRE AVE STE B, SANTA ANA, CA 92705-4783
(714) 573-8585
(714) 544-2189
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ61648Y
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
08/03/2010
Last updated
08/03/2010
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