Organization
LA SPORTS REHAB INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARAK MEVORAK MD (PRESIDENT)
(310) 575-0935
Entity
Organization
Contact information
Practice address
10780 SANTA MONICA BLVD, SUITE 333, LOS ANGELES, CA 90025-4749
(310) 575-0935
Mailing address
10780 SANTA MONICA BLVD, SUITE 333, LOS ANGELES, CA 90025-4749
(310) 575-0935
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A75933
CA
Other
Enumeration date
05/13/2010
Last updated
05/13/2010
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