Healthcare Provider Details

I. General information

NPI: 1124064076
Provider Name (Legal Business Name): CHRISTY MALONZO PHYSICAL THERAPIST INC. & MANJIRI DAHDUL PHYSICAL THER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3294 E. SPRING STREET
LONG BEACH CA
90806-2426
US

IV. Provider business mailing address

3294 E. SPRING STREET
LONG BEACH CA
90806-2426
US

V. Phone/Fax

Practice location:
  • Phone: 562-988-3570
  • Fax: 562-988-3671
Mailing address:
  • Phone: 562-988-3570
  • Fax: 562-988-3671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number28635
License Number StateCA

VIII. Authorized Official

Name: MANJIRI D DAHDUL
Title or Position: DIRECTOR
Credential: DPT
Phone: 562-988-3570