Healthcare Provider Details

I. General information

NPI: 1144267493
Provider Name (Legal Business Name): CAHILL PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11740 SAN VICENTE BLVD #205
LOS ANGELES CA
90049-6610
US

IV. Provider business mailing address

11740 SAN VICENTE BLVD #205
LOS ANGELES CA
90049-6610
US

V. Phone/Fax

Practice location:
  • Phone: 310-820-7602
  • Fax: 310-820-7818
Mailing address:
  • Phone: 310-820-7602
  • Fax: 310-820-7818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberDPT15814
License Number StateCA

VIII. Authorized Official

Name: MS. CATHERINE CAHILL
Title or Position: PRESIDENT/OWNER
Credential: DPT
Phone: 310-820-7602