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NPI Code Detail

MEDICARE: ELLEN SARAH KNOTT PT, DPT

MEDICARE:   ELLEN SARAH KNOTT  PT, 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
12251P0200XPediatric Physical TherapistPT43311CA

General Provider Information

NPI Number : 1104389873
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN SARAH KNOTT PT, DPT
Provider Business Mailing Address
First Line : 13075 PACIFIC PROMENADE APT 105
Second Line :
City : PLAYA VISTA
State : CA
Zip : 90094-2109
Country : US
Telephone Number : 818-631-4334
Fax Number :
Provider Business Practice Location Address
First Line : 13075 PACIFIC PROMENADE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90094-2110
Country : US
Telephone Number : 818-631-4334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2019
Last Update Date : 05/29/2024

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