Healthcare Provider Details

I. General information

NPI: 1225815822
Provider Name (Legal Business Name): AJ PT WEST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 09/08/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23586 CALABASAS RD CALABASAS SUITE 103
ENCINO CA
91302-1322
US

IV. Provider business mailing address

16573 VENTURA BLVD SUITE 8
ENCINO CA
91436-2024
US

V. Phone/Fax

Practice location:
  • Phone: 818-986-7266
  • Fax: 818-287-6783
Mailing address:
  • Phone: 818-986-7266
  • Fax: 818-287-6783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: BARAK KRAUS
Title or Position: OWNER
Credential: DPT
Phone: 818-986-7266