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General NPI Number Information
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NPI Number | 1073813986
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Entity Type | Organization
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Legal Business Name | BLOOMING STEPS PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 4955 VAN NUYS BLVD # 419
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1801
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Country | US
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Telephone | 818-917-0828
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Fax |
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Provider Business Mailing Address
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Address Line | 4055 LANKERSHIM BLVD APT 421
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City | STUDIO CITY
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State | CA
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Zip | 91604-3438
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Country | US
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Telephone | 818-917-0828
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY
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Name | DR. PAMELA VARTANIAN
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Credential | DPT
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Telephone | 818-917-0828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 25141
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License Number State | CA
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