=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962354985
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EVANGELOS RAPTODIMOS LMT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/11/2026
-----------------------------------------------------
Last Update Date | 02/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3675 HUNTINGTON DR STE 205
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91107-5645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-228-5676
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 29120 MEDEA LN APT 1306
-----------------------------------------------------
City | AGOURA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91301-6426
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-300-3221
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 69471
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------