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NPI Code Detail

MEDICARE: CENTURY CITY PHYSICAL THERAPY, INC

MEDICARE: CENTURY CITY 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
1208100000XPhysical Medicine & Rehabilitation PhysicianW14533CA

General Provider Information

NPI Number : 1053318337
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTURY CITY PHYSICAL THERAPY, INC
Provider Business Mailing Address
First Line : 2080 CENTURY PARK E
Second Line : SUITE 410
City : LOS ANGELES
State : CA
Zip : 90067-2001
Country : US
Telephone Number : 310-553-2519
Fax Number : 310-553-5842
Provider Business Practice Location Address
First Line : 2080 CENTURY PARK E
Second Line : SUITE 410
City : LOS ANGELES
State : CA
Zip : 90067-2001
Country : US
Telephone Number : 310-553-2519
Fax Number : 310-553-5842
Authorized Official
Title or Position : OWNER
Name : SUSAN BASS
Credential : R.P.T.
Telephone Number : 310-553-2519
Provider Enumeration Date : 07/01/2005
Last Update Date : 06/23/2014

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Practice Location Address:
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1023002813 — MITCHELL E COHEN M.D.
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Directions to “CENTURY CITY PHYSICAL THERAPY, INC ” Practice Location

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