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General NPI Number Information
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NPI Number | 1326549304
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Entity Type | Individual
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Provider Name | CARLY ANN CANO PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 13425 VENTURA BLVD STE 200
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-3997
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Country | US
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Telephone | 818-877-6910
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Fax |
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Provider Business Mailing Address
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Address Line | 111 SPARROWHAWK LN
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City | OAK PARK
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State | CA
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Zip | 91377-1016
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Country | US
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Telephone | 818-456-6641
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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 | 294562
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License Number State | CA
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