1700127610 NPI number — MISS JULIANNE FRANCES KELMAN D.P.T.

Table of content: MISS JULIANNE FRANCES KELMAN D.P.T. (NPI 1700127610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700127610 NPI number — MISS JULIANNE FRANCES KELMAN D.P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KELMAN
Provider First Name:
JULIANNE
Provider Middle Name:
FRANCES
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
D.P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700127610
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11260 OVERLAND AVE APT 6D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CULVER CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90230-5529
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-585-4295
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
321 N. LARCHMONT BLVD. #825
Provider Second Line Business Practice Location Address:
LARCHMONT PHYSICAL THERAPY
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90004-6400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-464-4458
Provider Business Practice Location Address Fax Number:
323-464-5329
Provider Enumeration Date:
03/04/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2251X0800X , with the licence number:  PT39873 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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