Healthcare Provider Details

I. General information

NPI: 1003195579
Provider Name (Legal Business Name): LEENA URANWALA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2011
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23388 MULHOLLAND DR SABAN CENTER
WOODLAND HILLS CA
91364-2733
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 818-876-1006
  • Fax: 818-876-0542
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number38108
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: