Healthcare Provider Details

I. General information

NPI: 1760392120
Provider Name (Legal Business Name): REDD AUSTRIA PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 TRUMAN ST
SAN FERNANDO CA
91340-3203
US

IV. Provider business mailing address

25115 AVENUE STANFORD STE B215
VALENCIA CA
91355-1290
US

V. Phone/Fax

Practice location:
  • Phone: 818-403-6559
  • Fax:
Mailing address:
  • Phone: 661-250-9940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number311021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: