Healthcare Provider Details

I. General information

NPI: 1568387025
Provider Name (Legal Business Name): NEAL SAMIANA-TAITANO PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6086 COMEY AVE
LOS ANGELES CA
90034-2204
US

IV. Provider business mailing address

22611 FIGUEROA ST UNIT 1/4
CARSON CA
90745-4414
US

V. Phone/Fax

Practice location:
  • Phone: 424-250-2024
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: