Healthcare Provider Details

I. General information

NPI: 1083213961
Provider Name (Legal Business Name): PROFIZIX PHYSICAL THERAPY AND WELLNESS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3392 MOTOR AVE
LOS ANGELES CA
90034-3712
US

IV. Provider business mailing address

3392 MOTOR AVE
LOS ANGELES CA
90034-3712
US

V. Phone/Fax

Practice location:
  • Phone: 310-742-2230
  • Fax: 310-659-4626
Mailing address:
  • Phone: 310-742-2230
  • Fax: 310-659-4626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. NAZANIN AMINI
Title or Position: OWNER
Credential: DPT
Phone: 310-742-2230