Provider Demographics
NPI:1740358217
Name:PAUL, LOUIS (RPT)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:PAUL
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 1:16426 KITTRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-5792
Mailing Address - Country:US
Mailing Address - Phone:310-908-4499
Mailing Address - Fax:
Practice Address - Street 1:7188 W SUNSET BLVD STE 201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-4446
Practice Address - Country:US
Practice Address - Phone:213-925-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPIT2580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist