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General NPI Number Information
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NPI Number | 1013129485
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Entity Type | Individual
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Provider Name | HARRY HIROSHI MITA PT
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Gender | Male
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Dates
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Enumeration Date | 05/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 420 E 3RD ST #703
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City | LOS ANGELES
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State | CA
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Zip | 90013-1644
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Country | US
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Telephone | 213-687-3278
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Fax | 213-680-2010
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Provider Business Mailing Address
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Address Line | 2216 E PETUNIA ST
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City | GLENDORA
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State | CA
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Zip | 91740-4644
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Country | US
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Telephone | 626-852-0844
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT13035
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License Number State | CA
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