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General NPI Number Information
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NPI Number | 1104581685
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Entity Type | Organization
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Legal Business Name | RAPHA HOUSE PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 11/01/2021
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 16632 HAYNES ST
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City | LAKE BALBOA
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State | CA
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Zip | 91406-5619
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Country | US
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Telephone | 747-200-5653
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Fax |
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Provider Business Mailing Address
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Address Line | 16350 VENTURA BLVD STE D-160
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City | ENCINO
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State | CA
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Zip | 91436-5300
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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 | PRESIDENT AND PHYSICAL THERAPIST
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Name | MARC SONDREAL
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Credential | PT
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Telephone | 747-200-5653
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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 |
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License Number State |
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