MEDICARE: JESUS ALMANZA 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
1	225100000X	Physical Therapist	35226	CA

General Provider Information

NPI Number	:	1376789719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESUS ALMANZA DPT

Provider Business Mailing Address
First Line	:	1414 S. CATALINA ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006
Country	:	US
Telephone Number	:	818-637-2127
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 W GLENOAKS BLVD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2813
Country	:	US
Telephone Number	:	818-637-2127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2009
Last Update Date	:	01/06/2009

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Directions to “ JESUS ALMANZA DPT” Practice Location

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