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General NPI Number Information
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NPI Number | 1205696127
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Entity Type | Individual
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Provider Name | CHRIS MORALES
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Gender | Male
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Dates
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Enumeration Date | 03/19/2024
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 11611 SAN VICENTE BLVD STE GF4
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City | LOS ANGELES
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State | CA
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Zip | 90049-6515
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Country | US
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Telephone | 424-246-9594
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Fax |
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Provider Business Mailing Address
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Address Line | 28214 SPRINGVALE LN
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City | CASTAIC
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State | CA
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Zip | 91384-3814
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Country | US
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Telephone | 818-914-9786
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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 | 305382
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License Number State | CA
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