Healthcare Provider Details

I. General information

NPI: 1831901248
Provider Name (Legal Business Name): EDDIE ULUCHYAN PHYSIOTHERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 N JACKSON ST
GLENDALE CA
91207-1416
US

IV. Provider business mailing address

1322 N JACKSON ST
GLENDALE CA
91207-1416
US

V. Phone/Fax

Practice location:
  • Phone: 818-640-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. EDDIE ULUCHYAN
Title or Position: PRESIDENT
Credential: PT, DPT
Phone: 818-640-2600