Provider Demographics
NPI:1508074816
Name:AMIRIAN, JOSEPH W (RPT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:W
Last Name:AMIRIAN
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 S. INDIANA ST.
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-1820
Mailing Address - Country:US
Mailing Address - Phone:323-268-1700
Mailing Address - Fax:323-268-6400
Practice Address - Street 1:810 S. INDIANA ST.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-1820
Practice Address - Country:US
Practice Address - Phone:323-268-1700
Practice Address - Fax:323-268-6400
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPT32333225100000X
CAPT323332251G0304X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist