Provider Demographics
NPI:1043559719
Name:BALDIOLI, ANA (PT)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:BALDIOLI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11717 DARLINGTON AVE
Mailing Address - Street 2:#5
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5555
Mailing Address - Country:US
Mailing Address - Phone:310-927-3743
Mailing Address - Fax:
Practice Address - Street 1:11717 DARLINGTON AVE
Practice Address - Street 2:#5
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-5555
Practice Address - Country:US
Practice Address - Phone:310-927-3743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35071225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist