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General NPI Number Information
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NPI Number | 1134937139
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Entity Type | Individual
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Provider Name | TATIANA RATAVOSIAN PT
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Gender | Female
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Dates
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Enumeration Date | 12/21/2024
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Last Update Date | 12/21/2024
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Provider Practice Location Address
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Address Line | 6420 WILSHIRE BLVD STE 600
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City | LOS ANGELES
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State | CA
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Zip | 90048-5521
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Country | US
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Telephone | 877-757-8353
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Fax |
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Provider Business Mailing Address
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Address Line | 10010 TUJUNGA CANYON BLVD APT D
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City | TUJUNGA
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State | CA
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Zip | 91042-2890
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Country | US
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Telephone | 818-530-8334
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | OR242722
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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 | 301898
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License Number State | CA
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