Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAH NINNESS-SEVERIOS D.P.T. (PHYSICAL THERAPIST)
(310) 913-3969
Entity
Organization
Contact information
Practice address
25825 SOUTH VERMONT AVE., HARBOR CITY, CA 90710
(310) 517-4060
Mailing address
1708 ESPLANADE APT 10, REDONDO BEACH, CA 90277-5326
(310) 913-3969
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
35342
CA
305R00000X
Preferred Provider Organization
Primary
35342
CA
Other
Enumeration date
01/26/2009
Last updated
01/26/2009
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