MEDICARE: RAD 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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1891637005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAD THERAPY, INC.

Provider Business Mailing Address
First Line	:	18017 CHATSWORTH ST
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-5608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18017 CHATSWORTH ST STE 321
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-5608
Country	:	US
Telephone Number	:	818-429-1516
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	RICHARD DAVITIAN
Credential	:
Telephone Number	:	818-429-1516

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “RAD THERAPY, INC. ” Practice Location

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