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General NPI Number Information
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NPI Number | 1528608825
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Entity Type | Organization
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Legal Business Name | PLEASANT POINT PT, CORP.
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 100 W BROADWAY STE 750
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City | GLENDALE
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State | CA
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Zip | 91210-1215
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Country | US
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Telephone | 323-419-4103
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Fax | 323-419-5507
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Provider Business Mailing Address
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Address Line | 100 W BROADWAY STE 750
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City | GLENDALE
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State | CA
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Zip | 91210-1215
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Country | US
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Telephone | 323-419-4103
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Fax | 323-419-5507
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Authorized Official
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Title or Position | CEO
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Name | MR. SEBASTIAN ERDMAN-WATERHOUSE
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Credential |
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Telephone | 323-419-4103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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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 |
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License Number State |
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