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General NPI Number Information
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NPI Number | 1447730775
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Entity Type | Individual
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Provider Name | MICHAEL STEVEN PLUDE JR. PT
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Gender | Male
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 438 S HAMEL RD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-3903
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Country | US
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Telephone | 310-272-5324
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Fax |
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Provider Business Mailing Address
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Address Line | 438 S HAMEL RD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-3903
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Country | US
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Telephone | 310-272-5324
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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 | 043447
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 299479
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License Number State | CA
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