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General NPI Number Information
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NPI Number | 1821275983
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Entity Type | Individual
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Provider Name | LISA PLUME P.T.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 1821 WILSHIRE BLVD
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City | SANTA MONICA
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State | CA
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Zip | 90403-5618
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Country | US
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Telephone | 310-453-6166
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Fax | 310-453-6154
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Provider Business Mailing Address
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Address Line | 881 ALMA REAL DR STE 311
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272
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Country | US
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Telephone | 310-454-0060
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Fax |
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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 | PT29330
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3021
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License Number State | HI
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