Provider Demographics
NPI:1407897879
Name:DREBEN, NEIL SCOTT (MPT)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:SCOTT
Last Name:DREBEN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23101 SHERMAN PL STE 150
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-2005
Mailing Address - Country:US
Mailing Address - Phone:818-887-7667
Mailing Address - Fax:818-887-7677
Practice Address - Street 1:23101 SHERMAN PL STE 150
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2005
Practice Address - Country:US
Practice Address - Phone:818-887-7667
Practice Address - Fax:818-887-7677
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT247202251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP13043Medicare UPIN