Organization
SPRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB COHEN (PHYSICAL THERAPIST)
(818) 986-1977
Entity
Organization
Contact information
Practice address
17922 SAN FERNANDO MISSION BLVD, GRANADA HILLS, CA 91344-4043
(818) 360-1864
Mailing address
16260 VENTURA BLVD, SUITE 600, ENCINO, CA 91436-2203
(818) 986-1977
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
SP5019
CA
Other
Enumeration date
01/06/2016
Last updated
01/19/2016
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