Individual
TAMAR WYTE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
10736 JEFFERSON BLVD, #172, CULVER CITY, CA 90230-4969
(310) 936-0224
(310) 823-2636
Mailing address
11260 OVERLAND AVE, #22A, CULVER CITY, CA 90230-5559
(310) 559-3427
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT26482
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT264820
BLUE SHIELD PROVIDER #
CA
Enumeration date
05/19/2006
Last updated
07/08/2007
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