Provider Demographics
NPI:1376581066
Name:PRZEBIEDA, DAREK (PT)
Entity Type:Individual
Prefix:
First Name:DAREK
Middle Name:
Last Name:PRZEBIEDA
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 1:1235 N PARISH PL
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1113
Mailing Address - Country:US
Mailing Address - Phone:818-841-8620
Mailing Address - Fax:818-841-8624
Practice Address - Street 1:1235 N PARISH PL
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1113
Practice Address - Country:US
Practice Address - Phone:818-841-8620
Practice Address - Fax:818-841-8624
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201712251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic