MEDICARE: MARIA ROOHI RPT

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	PT25011	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT25011	OTHER	CA	PHYSICAL THERAPIST

General Provider Information

NPI Number	:	1760438899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA ROOHI RPT

Provider Business Mailing Address
First Line	:	822 S ROBERTSON BLVD
Second Line	:	STE 106
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1630
Country	:	US
Telephone Number	:	310-657-7220
Fax Number	:

Provider Business Practice Location Address
First Line	:	822 S ROBERTSON BLVD
Second Line	:	STE 106
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1613
Country	:	US
Telephone Number	:	310-657-7220
Fax Number	:

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	04/30/2008

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Directions to “ MARIA ROOHI RPT” Practice Location

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