Most Relevant Information
Provider Data
| NPI Number: | 1003508474 |
| Provider Name: | JASON NAM PT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 304122 |
Most Important Dates
| Enumeration Date: | 05/24/2023 |
| Last Updated: | 05/24/2023 |
Provider Practice Location
520 S VIRGIL AVE STE 201
LOS ANGELES
CA
900201425
Practice Location Phone/Fax
| Phone: | 2133650023 |
| Fax: |
Provider Mailing Location
4218 VIA LARGO
CYPRESS
CA
906303450
Provider Mailing Phone/Fax
| Phone: | 7147333307 |
| Fax: |