Healthcare Provider Details

I. General information

NPI: 1134959638
Provider Name (Legal Business Name): JOSE LUIS ALANIZ JR. PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W ALAMEDA AVE
BURBANK CA
91506-2932
US

IV. Provider business mailing address

5545 KLUMP AVE APT 14
NORTH HOLLYWOOD CA
91601-2461
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number306587
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: