MEDICARE: TOLOS PHYSICAL THERAPY INC

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

General Provider Information

NPI Number	:	1457642571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOLOS PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	2514 OVERLAND AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-3333
Country	:	US
Telephone Number	:	310-837-8001
Fax Number	:	310-837-8007

Provider Business Practice Location Address
First Line	:	2514 OVERLAND AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-3333
Country	:	US
Telephone Number	:	310-837-8001
Fax Number	:	310-837-8007

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	CHRIS J. TOLOS
Credential	:	PT
Telephone Number	:	310-837-8001

Provider Enumeration Date	:	04/23/2011
Last Update Date	:	04/23/2011

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