Individual
TIMOTHY GAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
533 S FAIRFAX AVE, LOS ANGELES, CA 90036-3129
(323) 930-4815
Mailing address
3176 ATWATER AVE, LOS ANGELES, CA 90039-2404
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10870
CA
Other
Enumeration date
03/10/2016
Last updated
03/10/2016
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