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General NPI Number Information
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NPI Number | 1134897507
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Entity Type | Individual
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Provider Name | RACHEL QUAN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/01/2021
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 18411 CLARK ST STE 302
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City | TARZANA
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State | CA
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Zip | 91356-3541
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Country | US
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Telephone | 818-921-7702
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Fax |
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Provider Business Mailing Address
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Address Line | 4068 SAPPHIRE DR
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City | ENCINO
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State | CA
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Zip | 91436-3647
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Country | US
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Telephone | 818-624-9466
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 300660
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License Number State | CA
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