Provider Demographics
NPI:1396010112
Name:THOMPSON, CHERYL L (MPT)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:L
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6133 BRISTOL PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6670
Mailing Address - Country:US
Mailing Address - Phone:310-337-7600
Mailing Address - Fax:
Practice Address - Street 1:6133 BRISTOL PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6670
Practice Address - Country:US
Practice Address - Phone:310-337-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38813225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist