Healthcare Provider Details

I. General information

NPI: 1467051839
Provider Name (Legal Business Name): THE PELVIC MODEL PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2020
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6104 YORK BLVD
LOS ANGELES CA
90042-3542
US

IV. Provider business mailing address

6104 YORK BLVD
LOS ANGELES CA
90042-3542
US

V. Phone/Fax

Practice location:
  • Phone: 323-403-0234
  • Fax: 323-922-3277
Mailing address:
  • Phone: 323-403-0234
  • Fax: 323-922-3277

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: RACHEL DAOF
Title or Position: PRESIDENT
Credential: DPT
Phone: 323-207-0011