MEDICARE: SONJA ANN CHANDLER 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	2251X0800X	Orthopedic Physical Therapist	PT12306	CA

General Provider Information

NPI Number	:	1669480539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONJA ANN CHANDLER PT

Provider Business Mailing Address
First Line	:	822 S ROBERTSON BLVD
Second Line	:	SUITE 310
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1632
Country	:	US
Telephone Number	:	310-360-0882
Fax Number	:	310-360-0840

Provider Business Practice Location Address
First Line	:	822 S ROBERTSON BLVD
Second Line	:	SUITE 310
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1613
Country	:	US
Telephone Number	:	310-360-0882
Fax Number	:	310-360-0840

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	08/26/2010

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