Evolution Physical Therapy, Inc

Organization Active NPI Physical Therapist · Los Angeles, CA

NPI 1508049099 · NPPES record last updated Dec 7, 2007

Key facts

NPI
1508049099
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
EVOLUTION PHYSICAL THERAPY, INC
Practice address
11901 Santa Monica Blvd
202
Los Angeles, CA 90025-2767
Phone
(310) 479-2323
NPI assigned
Dec 7, 2007
Organization subpart
No

Authorized official

Name
Darwin Fogt, MPT
Title
President
Phone
(310) 305-7100

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 5

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

National Provider Directory

Tax ID family
Bebe PT (2 organizations share this tax ID)

Locations

11901 Santa Monica Blvd
Ste 202
Los Angeles, CA 90025
Phone (301) 341-4885

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X Yes

Addresses

Primary practice location

11901 Santa Monica Blvd
202
Los Angeles, CA 90025-2767

Mailing address

322 Culver Blvd
207
Playa del Rey, CA 90293-7704
Phone (310) 305-7100

Other names

  • Bebe PT Doing business as

Other providers in Los Angeles, CA

All providers in Los Angeles, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.