Healthcare Provider Details

I. General information

NPI: 1447924253
Provider Name (Legal Business Name): RACHEL OHARA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 03/27/2023
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28557 S MONTEREINA DR
RANCHO PALOS VERDES CA
90275-0881
US

IV. Provider business mailing address

28557 S MONTEREINA DR
RANCHO PALOS VERDES CA
90275-0881
US

V. Phone/Fax

Practice location:
  • Phone: 310-749-1808
  • Fax:
Mailing address:
  • Phone: 310-749-1808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT300253
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: