Healthcare Provider Details

I. General information

NPI: 1699692970
Provider Name (Legal Business Name): VANTAGE PHYSICAL THERAPY AND WELLNESS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22110 ROSCOE BLVD STE 106
WEST HILLS CA
91304-3870
US

IV. Provider business mailing address

22110 ROSCOE BLVD STE 106
WEST HILLS CA
91304-3870
US

V. Phone/Fax

Practice location:
  • Phone: 818-634-4376
  • Fax:
Mailing address:
  • Phone: 818-634-4376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DIPTI NAIDU
Title or Position: PRESIDENT/PHYSICAL THERAPIST
Credential: PT
Phone: 818-634-4376