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General NPI Number Information
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NPI Number | 1063534410
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Entity Type | Individual
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Provider Name | SEAN DANIEL RUNDELL DPT
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Gender | Male
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Dates
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Enumeration Date | 04/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5601 DE SOTO AVE
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6701
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Country | US
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Telephone | 818-719-2931
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Fax |
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Provider Business Mailing Address
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Address Line | 5535 CANOGA AVE #212
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6632
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Country | US
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Telephone |
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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 | 33384
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5025
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License Number State | OR
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