Healthcare Provider Details

I. General information

NPI: 1801235759
Provider Name (Legal Business Name): PHYSICAL THERAPY WEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44303 LOWTREE AVE
LANCASTER CA
93534-4149
US

IV. Provider business mailing address

21781 VENTURA BLVD #438
WOODLAND HILLS CA
91364-1835
US

V. Phone/Fax

Practice location:
  • Phone: 661-940-5494
  • Fax: 661-940-0825
Mailing address:
  • Phone: 818-257-2572
  • 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. YARON PETERS
Title or Position: OWNER/DIRECTOR
Credential: DPT
Phone: 818-257-2572