=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861534984
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHAEL B SCHLINK INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2007
-----------------------------------------------------
Last Update Date | 01/29/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10780 SANTA MONICA BLVD SUITE 480
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90025-4749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-474-5150
-----------------------------------------------------
Fax | 310-474-4924
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4253 NOELINE AVE
-----------------------------------------------------
City | ENCINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91436-3329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-474-5150
-----------------------------------------------------
Fax | 310-474-4924
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | MICHAEL B. SCHLINK
-----------------------------------------------------
Credential | MA, PT
-----------------------------------------------------
Telephone | 310-474-5150
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT8784
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------