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NPI Code Detail

MEDICARE: MR. ERIC LICHTENSTEIN PT, DPT

MEDICARE: MR. ERIC LICHTENSTEIN 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
1225100000XPhysical Therapist42926CA

General Provider Information

NPI Number : 1225405517
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ERIC LICHTENSTEIN PT, DPT
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 :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2015
Last Update Date : 07/21/2022

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