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General NPI Number Information
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NPI Number | 1780820787
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Entity Type | Organization
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Legal Business Name | FPTC MANAGEMENT INC.
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 03/08/2020
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Provider Practice Location Address
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Address Line | 12011 SAN VICENTE BLVD SUITE B-5
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City | LOS ANGELES
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State | CA
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Zip | 90049-4926
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Country | US
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Telephone | 310-476-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 12011 SAN VICENTE BLVD SUITE B-5
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City | LOS ANGELES
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State | CA
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Zip | 90049-4926
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Country | US
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Telephone | 310-476-3600
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER/PHYSICAL THERAPIST
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Name | MR. JONATHAN CASLER
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Credential | MPT
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Telephone | 310-476-3600
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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 | PT26723
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License Number State | CA
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