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General NPI Number Information
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NPI Number | 1205438850
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Entity Type | Individual
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Provider Name | MICHEL ADAM DE ANGELIS DPT
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Gender | Male
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 2001 W ALAMEDA AVE
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City | BURBANK
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State | CA
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Zip | 91506-2932
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Country | US
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Telephone | 818-953-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 2748 MONTROSE AVE APT 15
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City | MONTROSE
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State | CA
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Zip | 91020-1345
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Country | US
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Telephone | 818-314-0808
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT299464
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License Number State | CA
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