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NPI Code Detail

MEDICARE: MANDANA HODJATI

MEDICARE: MANDANA HODJATI
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 Therapist2305206484VA
2225100000XPhysical Therapist293025CA

General Provider Information

NPI Number : 1568763050
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANDANA HODJATI
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number : 310-301-5138
Fax Number :
Provider Business Practice Location Address
First Line : 10250 SANTA MONICA BLVD STE 2440
Second Line :
City : LOS ANGELES
State : CA
Zip : 90067-6593
Country : US
Telephone Number : 310-286-0122
Fax Number : 310-286-0125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2010
Last Update Date : 05/09/2022

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Directions to “ MANDANA HODJATI ” Practice Location

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