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General NPI Number Information
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NPI Number | 1780123075
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Entity Type | Organization
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Legal Business Name | KINETIC ORTHOPAEDIC PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 06/16/2017
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Provider Practice Location Address
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Address Line | 1950 SAWTELLE BLVD SUITE 190
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City | LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 310-312-5678
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 SAWTELLE BLVD SUITE 190
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City | LOS ANGELES
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State | CA
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Zip | 90025-7014
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Country | US
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Telephone | 310-312-5678
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. DAVID H. PAKOZDI
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Credential | PT, OCS
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Telephone | 310-312-5678
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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 | PT10216
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License Number State | CA
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