Healthcare Provider Details

I. General information

NPI: 1760831796
Provider Name (Legal Business Name): DIANE KAHLER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 E CHAPMAN AVE STE C
ORANGE CA
92866-2152
US

IV. Provider business mailing address

1026 E CHAPMAN AVE STE C
ORANGE CA
92866-2152
US

V. Phone/Fax

Practice location:
  • Phone: 714-538-1952
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT291411
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: