Healthcare Provider Details

I. General information

NPI: 1174854376
Provider Name (Legal Business Name): ANNE J HA RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 11/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 W OLYMPIC BLVD SUITE 302
LOS ANGELES CA
90006-2637
US

IV. Provider business mailing address

14097 TIGER LILY CT
EASTVALE CA
92880-3227
US

V. Phone/Fax

Practice location:
  • Phone: 213-382-0088
  • Fax: 213-380-2038
Mailing address:
  • Phone: 213-215-3371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number29011
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: