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General NPI Number Information
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NPI Number | 1124452420
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Entity Type | Organization
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Legal Business Name | VILLALUNA PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 08/23/2013
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 19100 VENTURA BLVD #7
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City | TARZANA
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State | CA
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Zip | 91356-3239
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Country | US
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Telephone | 702-338-1893
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Fax |
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Provider Business Mailing Address
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Address Line | 4924 BALBOA BLVD #531
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City | ENCINO
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State | CA
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Zip | 91316-3402
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Country | US
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Telephone | 702-338-1893
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RHODA VILLALUNA
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Credential | P.T.
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Telephone | 702-338-1893
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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 | 28423
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License Number State | CA
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