Healthcare Provider Details

I. General information

NPI: 1356253488
Provider Name (Legal Business Name): CHETHAN MATHARU PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 SEPULVEDA BLVD
TORRANCE CA
90505-2719
US

IV. Provider business mailing address

5325 IRONWOOD ST
RANCHO PALOS VERDES CA
90275-1757
US

V. Phone/Fax

Practice location:
  • Phone: 424-488-6340
  • Fax:
Mailing address:
  • Phone: 310-386-7306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number311100
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: