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General NPI Number Information
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NPI Number | 1982169595
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Entity Type | Organization
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Legal Business Name | ORIGIN PHYSICAL THERAPY (CA), INC.
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Dates
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Enumeration Date | 02/07/2019
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 11980 SAN VICENTE BLVD STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90049-5012
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Country | US
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Telephone | 310-241-4885
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Fax | 310-479-2329
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Provider Business Mailing Address
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Address Line | PO BOX 103230
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City | PASADENA
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State | CA
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Zip | 91189-3230
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Country | US
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Telephone | 310-479-2323
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Fax | 310-479-2329
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Authorized Official
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Title or Position | MANAGER
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Name | SARAH CLAMPETT
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Credential |
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Telephone | 213-898-2673
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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 |
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License Number State |
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