Provider Demographics
NPI:1669480539
Name:CHANDLER, SONJA ANN (PT)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:ANN
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 S ROBERTSON BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1632
Mailing Address - Country:US
Mailing Address - Phone:310-360-0882
Mailing Address - Fax:310-360-0840
Practice Address - Street 1:822 S ROBERTSON BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1613
Practice Address - Country:US
Practice Address - Phone:310-360-0882
Practice Address - Fax:310-360-0840
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT123062251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT12306Medicare ID - Type Unspecified