Healthcare Provider Details

I. General information

NPI: 1669480539
Provider Name (Legal Business Name): SONJA ANN CHANDLER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 S ROBERTSON BLVD SUITE 310
LOS ANGELES CA
90035-1613
US

IV. Provider business mailing address

822 S ROBERTSON BLVD SUITE 310
LOS ANGELES CA
90035-1632
US

V. Phone/Fax

Practice location:
  • Phone: 310-360-0882
  • Fax: 310-360-0840
Mailing address:
  • Phone: 310-360-0882
  • Fax: 310-360-0840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT12306
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: