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General NPI Number Information
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NPI Number | 1942767561
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Entity Type | Individual
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Provider Name | SOPHIA QADIR DPT
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Gender | Female
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Dates
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Enumeration Date | 03/01/2019
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Last Update Date | 03/01/2019
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Provider Practice Location Address
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Address Line | 11858 1/2 BALBOA BLVD
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City | GRANADA HILLS
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State | CA
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Zip | 91344-2762
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Country | US
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Telephone | 818-217-4751
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Fax |
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Provider Business Mailing Address
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Address Line | 17117 CREST HEIGHTS DR
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City | SANTA CLARITA
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State | CA
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Zip | 91387-3177
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Country | US
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Telephone | 818-271-1738
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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 | 296273
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License Number State | CA
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