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General NPI Number Information
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NPI Number | 1982201406
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Entity Type | Individual
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Provider Name | NABBIN SONNY CHAMMACHEL PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 13652 CANTARA ST
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City | PANORAMA CITY
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State | CA
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Zip | 91402-5423
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Country | US
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Telephone | 833-574-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 17621 RYAN LN
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City | ORLAND PARK
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State | IL
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Zip | 60467-9349
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Country | US
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Telephone | 708-557-4714
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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 | 299185
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License Number State | CA
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