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General NPI Number Information
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NPI Number | 1538218136
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Entity Type | Individual
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Provider Name | MICHAEL SEAN HAMPTON MPT
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 10635 SANTA MONICA BLVD STE 165
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City | LOS ANGELES
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State | CA
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Zip | 90025-8306
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Country | US
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Telephone | 310-481-0644
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Fax | 310-474-4034
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Provider Business Mailing Address
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Address Line | 10635 SANTA MONICA BLVD STE 165
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City | LOS ANGELES
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State | CA
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Zip | 90025-8306
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Country | US
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Telephone | 310-481-0644
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Fax | 310-474-4034
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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 | PT19916
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License Number State | CA
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