MEDICARE: FABRIZIO PHYSICAL THERAPY AND SPORTS MEDICINE, 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	174400000X	Specialist	17758	CA

General Provider Information

NPI Number	:	1770650277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FABRIZIO PHYSICAL THERAPY AND SPORTS MEDICINE, INC

Provider Business Mailing Address
First Line	:	10309 SANTA MONICA BLVD STE 200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5007
Country	:	US
Telephone Number	:	310-553-5984
Fax Number	:	310-553-5986

Provider Business Practice Location Address
First Line	:	10309 SANTA MONICA BLVD STE 200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5007
Country	:	US
Telephone Number	:	310-553-5984
Fax Number	:	310-553-5986

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	DAVID MICHAEL FABRIZIO
Credential	:	PT, OCS
Telephone Number	:	310-553-5984

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	12/15/2025

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