Healthcare Provider Details

I. General information

NPI: 1053343459
Provider Name (Legal Business Name): DSC PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1346 FOOTHILL BLVD SUITE 101
LA CANADA CA
91011-2122
US

IV. Provider business mailing address

1346 FOOTHILL BLVD SUITE 101
LA CANADA CA
91011-2122
US

V. Phone/Fax

Practice location:
  • Phone: 818-790-3001
  • Fax: 818-790-9732
Mailing address:
  • Phone: 818-790-3001
  • Fax: 818-790-9732

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: MR. SANFORD L. SHEKLOW
Title or Position: DIRECTOR OF SERVICES
Credential: PT
Phone: 818-790-3001