Provider Demographics
NPI:1740313543
Name:JOSEPH S. LUK PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:JOSEPH S. LUK PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:LUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-265-9790
Mailing Address - Street 1:1530 E CHEVY CHASE DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4163
Mailing Address - Country:US
Mailing Address - Phone:818-265-9790
Mailing Address - Fax:
Practice Address - Street 1:1530 E CHEVY CHASE DR
Practice Address - Street 2:SUITE 109
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4163
Practice Address - Country:US
Practice Address - Phone:818-265-9790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT6698225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT6698AMedicare ID - Type UnspecifiedMEDICARE NHIC