Healthcare Provider Details

I. General information

NPI: 1881059848
Provider Name (Legal Business Name): JOSHUA CHAMBERS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2015
Last Update Date: 12/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 BALBOA BLVD STE 202
ENCINO CA
91316-2889
US

IV. Provider business mailing address

17801 DONMETZ ST
GRANADA HILLS CA
91344-4013
US

V. Phone/Fax

Practice location:
  • Phone: 818-986-4100
  • Fax:
Mailing address:
  • Phone: 719-671-1942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number43514
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: