Healthcare Provider Details

I. General information

NPI: 1134833320
Provider Name (Legal Business Name): MICHELLE CHELEPYAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 10/27/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W ALAMEDA AVE
BURBANK CA
91506-2932
US

IV. Provider business mailing address

903 E ELMWOOD AVE
BURBANK CA
91501-1531
US

V. Phone/Fax

Practice location:
  • Phone: 818-953-4444
  • Fax:
Mailing address:
  • Phone: 818-636-3907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number303281
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: