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General NPI Number Information
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NPI Number | 1376009506
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Entity Type | Individual
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Provider Name | KYLE NICHOLAS LLORENS PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 2925 W 141ST ST
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City | GARDENA
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State | CA
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Zip | 90249-2705
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Country | US
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Telephone | 310-755-8001
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 W 141ST ST
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City | GARDENA
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State | CA
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Zip | 90249-2705
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Country | US
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Telephone |
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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 | 308776
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License Number State | CA
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