MEDICARE: JEFFREY SAKBURANAPHAT 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	306622	CA

General Provider Information

NPI Number	:	1548126105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY SAKBURANAPHAT DPT

Provider Business Mailing Address
First Line	:	13423 BRACKEN ST
Second Line	:
City	:	ARLETA
State	:	CA
Zip	:	91331-5708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 S BUENA VISTA ST
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4809
Country	:	US
Telephone Number	:	818-843-5111
Fax Number	:

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

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	12/29/2025

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