Healthcare Provider Details
I. General information
NPI: 1902539331
Provider Name (Legal Business Name): DB PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/04/2022
Last Update Date: 07/04/2022
Certification Date: 07/04/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
822 S ROBERTSON BLVD STE 310
LOS ANGELES CA
90035-1632
US
IV. Provider business mailing address
822 S ROBERTSON BLVD STE 310
LOS ANGELES CA
90035-1632
US
V. Phone/Fax
- Phone: 310-360-9069
- Fax:
- Phone: 310-360-9069
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAMON
BROWN
Title or Position: OWNER
Credential: PT, DPT
Phone: 310-360-9069