Provider Demographics
NPI:1326057761
Name:WEXLER, MARTIN LEWIS (PT)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:LEWIS
Last Name:WEXLER
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 1:18641 TARZANA DR
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4512
Mailing Address - Country:US
Mailing Address - Phone:818-776-0503
Mailing Address - Fax:
Practice Address - Street 1:9700 DE SOTO AVE
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-4409
Practice Address - Country:US
Practice Address - Phone:818-882-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist