Healthcare Provider Details

I. General information

NPI: 1306140801
Provider Name (Legal Business Name): ANNETTE TAMRAZ PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2010
Last Update Date: 01/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N CENTRAL AVE STE 220
GLENDALE CA
91202-2957
US

IV. Provider business mailing address

1000 N CENTRAL AVE STE 220
GLENDALE CA
91202-2957
US

V. Phone/Fax

Practice location:
  • Phone: 818-243-8422
  • Fax: 818-243-8444
Mailing address:
  • Phone: 818-243-8422
  • Fax: 818-243-8444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT27963
License Number StateCA

VIII. Authorized Official

Name: MS. ANNETTE TAMRAZ
Title or Position: PRESIDENT
Credential: MPT, OCS
Phone: 818-243-8422