Healthcare Provider Details

I. General information

NPI: 1477829638
Provider Name (Legal Business Name): DINO C BELLO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2012
Last Update Date: 01/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 W OLYMPIC BLVD 302
LOS ANGELES CA
90006-2207
US

IV. Provider business mailing address

2140 W OLYMPIC BLVD 302
LOS ANGELES CA
90006-2207
US

V. Phone/Fax

Practice location:
  • Phone: 213-487-7792
  • Fax: 213-487-7823
Mailing address:
  • Phone: 213-487-7792
  • Fax: 213-487-7823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number032666
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 39804
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: