Healthcare Provider Details

I. General information

NPI: 1558055921
Provider Name (Legal Business Name): PARACLETE 38 PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 08/24/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 WOODLAKE AVE STE 275
WEST HILLS CA
91307-1477
US

IV. Provider business mailing address

7320 WOODLAKE AVE STE 275
WEST HILLS CA
91307-1477
US

V. Phone/Fax

Practice location:
  • Phone: 818-322-9700
  • Fax:
Mailing address:
  • Phone: 747-226-0029
  • Fax: 747-226-0583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN YAMBAO NABONG
Title or Position: PRESIDENT
Credential:
Phone: 818-322-9700