Brentwood Physical Therapy Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT24158 Issued in CA

Legal business name

BRENTWOOD PHYSICAL THERAPY INC

Practice address

13050 San Vicente Blvd
#119
Los Angeles, CA 90049-4852

Phone

(310) 312-0022

NPI assigned

Apr 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gregg Walski

Title

Owner

Phone

(310) 312-0022

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lori Ann Hicks, M.P.T.

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1861603458
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235353681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13050 SAN VICENTE BLVD",
            "address_2": "#119",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900494852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13050 SAN VICENTE BLVD",
            "address_2": "#119",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900494852",
            "telephone_number": "310-312-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALSKI",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-312-0022"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT24158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brentwood Ambulatory Surgical Medical Center
• Brentwood Center for Advanced Medicine, PC (Bernhoft Center for Advanced Medicine)
• Brentwood Dermatology Medical Group Inc
• Brentwood Medical Group a Professional Medical Corp
• Brentwood Orthopedic and Spine Surgery LLC
• Brentwood Surgery Center Inc.
• Shelly Elise Brentzel, NP
• Heather Jeanne Bresett
• David Bresler II, M.D.
• David E Bresler, PHD, LAC, DIPLAC,

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.