Provider Demographics
NPI:1679827083
Name:PETERS, YARON (DPT)
Entity Type:Individual
Prefix:DR
First Name:YARON
Middle Name:
Last Name:PETERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16260 VENTURA BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2203
Mailing Address - Country:US
Mailing Address - Phone:818-257-2572
Mailing Address - Fax:818-986-4757
Practice Address - Street 1:44303 LOWTREE AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4149
Practice Address - Country:US
Practice Address - Phone:661-940-5494
Practice Address - Fax:661-940-0825
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist