Individual
ROBERT BEHYAD BANIASADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
612 E JANSS RD, THOUSAND OAKS, CA 91360-5113
(805) 373-0725
(805) 373-0574
Mailing address
8510 BALBOA BLVD, STE 150, NORTHRIDGE, CA 91325-3583
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10280
CA
Other
Enumeration date
01/17/2017
Last updated
01/17/2017
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