MEDICARE: PHYSICIANS CHOICE PHYSICAL THERAPY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ666372	OTHER	CA	BLUE SHIELDS PREF. PROV.

General Provider Information

NPI Number	:	1043226665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS CHOICE PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	12217 SANTA MONICA BLVD STE 209
Second Line	:
City	:	WEST LOS ANGELES
State	:	CA
Zip	:	90025-2589
Country	:	US
Telephone Number	:	310-309-3721
Fax Number	:	310-309-3724

Provider Business Practice Location Address
First Line	:	12217 SANTA MONICA BLVD STE 209
Second Line	:
City	:	WEST LOS ANGELES
State	:	CA
Zip	:	90025
Country	:	US
Telephone Number	:	310-309-3721
Fax Number	:	310-309-3724

Authorized Official
Title or Position	:	OWNER
Name	:	GAURAVI MERCHANT
Credential	:	RPT
Telephone Number	:	310-309-3721

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	03/25/2026

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Directions to “PHYSICIANS CHOICE PHYSICAL THERAPY INC ” Practice Location

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