Healthcare Provider Details

I. General information

NPI: 1740956630
Provider Name (Legal Business Name): OFEK MILLER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 01/28/2024
Certification Date: 01/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16573 VENTURA BLVD STE 8
ENCINO CA
91436-2024
US

IV. Provider business mailing address

19566 VENTURA BLVD
TARZANA CA
91356-2917
US

V. Phone/Fax

Practice location:
  • Phone: 818-986-7266
  • Fax: 818-907-3890
Mailing address:
  • Phone: 818-445-0280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT300672
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: