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NPI Code Detail

MEDICARE: ALEXANDRA LEIGH CARLIN PT, DPT

MEDICARE: ALEXANDRA LEIGH CARLIN PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist39555CA

General Provider Information

NPI Number : 1093050825
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA LEIGH CARLIN PT, DPT
Provider Business Mailing Address
First Line : 4515 OCEAN VIEW BLVD
Second Line : STE 350
City : LA CANADA
State : CA
Zip : 91011-1409
Country : US
Telephone Number : 509-499-2757
Fax Number :
Provider Business Practice Location Address
First Line : 12121 WILSHIRE BLVD STE 100
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-1221
Country : US
Telephone Number : 310-477-7774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2012
Last Update Date : 07/21/2022

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