MEDICARE: KARENA LEE 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
1	225100000X	Physical Therapist	PT 25583	CA

General Provider Information

NPI Number	:	1326192188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARENA LEE PT

Provider Business Mailing Address
First Line	:	22151 CLARENDON ST
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-6308
Country	:	US
Telephone Number	:	818-884-4810
Fax Number	:	818-884-4802

Provider Business Practice Location Address
First Line	:	22151 CLARENDON ST
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-6308
Country	:	US
Telephone Number	:	818-884-4810
Fax Number	:	818-884-4802

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	08/03/2022

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