=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770650277
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FABRIZIO PHYSICAL THERAPY AND SPORTS MEDICINE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2006
-----------------------------------------------------
Last Update Date | 12/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10309 SANTA MONICA BLVD STE 200
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90025-5007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-553-5984
-----------------------------------------------------
Fax | 310-553-5986
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10309 SANTA MONICA BLVD STE 200
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90025-5007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-553-5984
-----------------------------------------------------
Fax | 310-553-5986
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DIRECTOR
-----------------------------------------------------
Name | DAVID MICHAEL FABRIZIO
-----------------------------------------------------
Credential | PT, OCS
-----------------------------------------------------
Telephone | 310-553-5984
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 17758
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------