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NPI Code Detail

MEDICARE: MICHAL TAL PT

MEDICARE:   MICHAL  TAL  PT
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 Therapist291319CA

General Provider Information

NPI Number : 1245518877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAL TAL PT
Provider Business Mailing Address
First Line : 8105 QUARTZ AVE
Second Line :
City : WINNETKA
State : CA
Zip : 91306-1942
Country : US
Telephone Number : 856-906-1516
Fax Number :
Provider Business Practice Location Address
First Line : 12626 RIVERSIDE DR
Second Line : STE 301
City : VALLEY VILLAGE
State : CA
Zip : 91607-3473
Country : US
Telephone Number : 818-760-0110
Fax Number : 818-301-0137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2011
Last Update Date : 10/26/2016

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Directions to “ MICHAL TAL PT” Practice Location

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