MEDICARE: DR. KRYSTA IOLA STIER DPT

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	38616	CA

General Provider Information

NPI Number	:	1053697516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRYSTA IOLA STIER DPT

Provider Business Mailing Address
First Line	:	4820 LINCOLN BLVD
Second Line	:
City	:	MARINA DEL REY
State	:	CA
Zip	:	90292-6917
Country	:	US
Telephone Number	:	310-822-0041
Fax Number	:	310-822-0049

Provider Business Practice Location Address
First Line	:	4820 LINCOLN BLVD
Second Line	:
City	:	MARINA DEL REY
State	:	CA
Zip	:	90292-6917
Country	:	US
Telephone Number	:	310-822-0041
Fax Number	:	310-822-0049

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2011
Last Update Date	:	03/19/2026

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