Provider Demographics
NPI:1386531788
Name:KOLINY, SEPEHR (DPT)
Entity type:Individual
Prefix:
First Name:SEPEHR
Middle Name:
Last Name:KOLINY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17000 VENTURA BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4187
Mailing Address - Country:US
Mailing Address - Phone:818-995-4488
Mailing Address - Fax:818-995-3140
Practice Address - Street 1:17000 VENTURA BLVD STE 103
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4187
Practice Address - Country:US
Practice Address - Phone:818-995-4488
Practice Address - Fax:818-995-3140
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT308130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist