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General NPI Number Information
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NPI Number | 1780838607
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Entity Type | Individual
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Provider Name | BRYNILLA PACHECO P.T.
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Gender | Female
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 09/26/2016
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Provider Practice Location Address
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Address Line | 500 E OLIVE AVE STE 325
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City | BURBANK
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State | CA
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Zip | 91501-3316
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Country | US
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Telephone | 818-955-5786
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Fax | 818-955-5789
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Provider Business Mailing Address
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Address Line | PO BOX 606
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City | BURBANK
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State | CA
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Zip | 91503-0606
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Country | US
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Telephone | 818-955-5786
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Fax | 818-955-5789
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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 | PT30424
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License Number State | CA
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