Healthcare Provider Details

I. General information

NPI: 1134224397
Provider Name (Legal Business Name): AMAN BROOKS ABYE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5478 WILSHIRE BLVD SUITE 208
LOS ANGELES CA
90036
US

IV. Provider business mailing address

5478 WILSHIRE BLVD STE 208
LOS ANGELES CA
90036-4225
US

V. Phone/Fax

Practice location:
  • Phone: 323-627-8054
  • Fax:
Mailing address:
  • Phone: 323-627-8054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 28757
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: