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General NPI Number Information
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NPI Number | 1295821429
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Entity Type | Organization
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Legal Business Name | FGB, INC.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4221 W KLING ST #20
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City | BURBANK
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State | CA
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Zip | 91505-3769
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Country | US
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Telephone | 818-635-3965
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Fax |
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Provider Business Mailing Address
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Address Line | 4221 W KLING ST #20
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City | BURBANK
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State | CA
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Zip | 91505-3769
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Country | US
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Telephone | 818-635-3965
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DAVID F CHARLET
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Credential | P.T.
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Telephone | 818-635-3965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT 20035
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License Number State | CA
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