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General NPI Number Information
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NPI Number | 1275641102
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Entity Type | Individual
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Provider Name | ELAHEH MOZAFFARIAN PT
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9745 PROSPECT AVE STE 102
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City | SANTEE
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State | CA
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Zip | 92071-4273
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Country | US
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Telephone | 619-449-8946
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Fax | 619-449-5127
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Provider Business Mailing Address
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Address Line | 5706 BALTIMORE DR #343
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City | LAMESA
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State | CA
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Zip | 91942-1655
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Country | US
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Telephone | 619-559-1449
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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 | PT6916
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License Number State | CA
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