Healthcare Provider Details

I. General information

NPI: 1619887999
Provider Name (Legal Business Name): ROBERT PROSSZER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 SAN FERNANDO RD
GLENDALE CA
91204-2944
US

IV. Provider business mailing address

3700 W SUNSET BLVD APT 10
LOS ANGELES CA
90026-1532
US

V. Phone/Fax

Practice location:
  • Phone: 323-936-7525
  • Fax:
Mailing address:
  • Phone: 424-599-6030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310984
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: