NPI Code Details Logo

NPI 1376420133

NPI 1376420133 : NOAH SPENCER MAHOOD : SOUTH PASADENA, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1376420133
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    NOAH SPENCER MAHOOD
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/21/2025
-----------------------------------------------------
    Last Update Date     |    08/21/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    625 FAIR OAKS AVE # 225 
-----------------------------------------------------
    City                 |    SOUTH PASADENA
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    91030-2630
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    626-737-6735
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3209 NEWTON ST 
-----------------------------------------------------
    City                 |    TORRANCE
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    90505-6609
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    310-325-0027
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapist
-----------------------------------------------------
    License Number       |    308780
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.