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General NPI Number Information
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NPI Number | 1689485666
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY & SPORTS MEDICINE
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 19932 VENTURA BLVD.
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City | WOODLAND HILLS
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State | CA
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Zip | 91364
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Country | US
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Telephone | 804-356-4540
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Fax |
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Provider Business Mailing Address
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Address Line | 18517 MARBELLA LANE
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City | TARZANA
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State | CA
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Zip | 91356
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Country | US
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Telephone | 804-356-4540
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SOHEILA EBADIAN
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Credential |
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Telephone | 804-356-4540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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