Provider Demographics
NPI:1235317587
Name:MINASSIAN, ALLEN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:MINASSIAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 FOOTHILL BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:LA CANADA FLINTRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91011-2107
Mailing Address - Country:US
Mailing Address - Phone:818-864-6479
Mailing Address - Fax:818-864-6429
Practice Address - Street 1:1434 FOOTHILL BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:LA CANADA FLINTRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91011-2107
Practice Address - Country:US
Practice Address - Phone:818-864-6479
Practice Address - Fax:818-864-6429
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT34070225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist