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General NPI Number Information
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NPI Number | 1376334045
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Entity Type | Individual
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Provider Name | MARS JIMENEZ DPT
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Gender | Female
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 201 N ROBERTSON BLVD
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1729
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Country | US
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Telephone | 424-303-7647
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Fax |
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Provider Business Mailing Address
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Address Line | 4830 ELMWOOD AVE APT 105
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City | LOS ANGELES
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State | CA
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Zip | 90004-3187
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Country | US
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Telephone | 310-941-2308
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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 | 307988
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License Number State | CA
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