MEDICARE: DR. ADELA SKUKA DPT

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	PT298000	CA

General Provider Information

NPI Number	:	1679226757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADELA SKUKA DPT

Provider Business Mailing Address
First Line	:	1540 VINE ST APT 702
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-4044
Country	:	US
Telephone Number	:	646-860-8574
Fax Number	:

Provider Business Practice Location Address
First Line	:	3995 OVERLAND AVE
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-3722
Country	:	US
Telephone Number	:	310-559-4999
Fax Number	:

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

Provider Enumeration Date	:	01/30/2022
Last Update Date	:	01/30/2022

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