Provider Demographics
NPI:1033817655
Name:GHOBRIAL, HANY MOHSEN (PT)
Entity Type:Individual
Prefix:MR
First Name:HANY
Middle Name:MOHSEN
Last Name:GHOBRIAL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6931 AMY AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-1401
Mailing Address - Country:US
Mailing Address - Phone:714-345-7990
Mailing Address - Fax:
Practice Address - Street 1:802 BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-1702
Practice Address - Country:US
Practice Address - Phone:626-359-8141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT-19816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist