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General NPI Number Information
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NPI Number | 1215815980
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Entity Type | Individual
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Provider Name | LOUDIJON GENISOIR PASCUAL PTA
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Gender | Male
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 12723 VENTURA BLVD
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City | STUDIO CITY
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State | CA
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Zip | 91604-2430
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Country | US
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Telephone | 800-976-7544
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Fax |
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Provider Business Mailing Address
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Address Line | 3590 BEVERLY GLEN BLVD
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City | SHERMAN OAKS
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State | CA
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Zip | 91423
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Country | US
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Telephone | 818-635-0387
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 51756
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License Number State | CA
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