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General NPI Number Information
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NPI Number | 1326677485
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Entity Type | Individual
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Provider Name | JENNY ASIM GADIA
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Gender | Female
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 07/24/2021
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Provider Practice Location Address
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Address Line | 3756 W AVENUE 40 STE 2B
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City | LOS ANGELES
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State | CA
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Zip | 90065-3667
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Country | US
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Telephone | 323-880-9938
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Fax | 323-344-2337
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Provider Business Mailing Address
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Address Line | 3756 W AVENUE 40 STE 2B
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City | LOS ANGELES
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State | CA
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Zip | 90065-3667
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Country | US
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Telephone | 323-880-9938
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Fax | 323-739-0094
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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 | PT295206
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License Number State | CA
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