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NPI Code Detail

MEDICARE: ELITE ORTHOSPORT PHYSICAL THERAPY

MEDICARE: ELITE ORTHOSPORT PHYSICAL THERAPY
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
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1215280706
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELITE ORTHOSPORT PHYSICAL THERAPY
Provider Business Mailing Address
First Line : 12121 WILSHIRE BLVD STE 100
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-1221
Country : US
Telephone Number : 310-477-7774
Fax Number : 310-477-7773
Provider Business Practice Location Address
First Line : 12121 WILSHIRE BLVD STE 100
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-1221
Country : US
Telephone Number : 310-477-7774
Fax Number : 310-477-7773
Authorized Official
Title or Position : PRESIDENT
Name : HEATHER MILLIGAN
Credential : PT
Telephone Number : 310-477-7774
Provider Enumeration Date : 10/21/2012
Last Update Date : 02/07/2022

Similar Medicare Providers

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Practice Location Address:
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Practice Fax:
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1093050825 — ALEXANDRA LEIGH CARLIN PT, DPT
Practice Location Address:
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90025-1221
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1225405517 — MR. ERIC LICHTENSTEIN PT, DPT
Practice Location Address:
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LOS ANGELES, CA
90025-1221
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1104371301 — DR. ROBIN VILLEDA ALDANA D.P.T.
Practice Location Address:
12121 WILSHIRE BLVD STE 100
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Practice Fax:

Directions to “ELITE ORTHOSPORT PHYSICAL THERAPY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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