Provider Demographics
NPI:1891840864
Name:MEHL, SYLVIA ANN (PT, OCS)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:ANN
Last Name:MEHL
Suffix:
Gender:F
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N AVIATION BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-7015
Mailing Address - Country:US
Mailing Address - Phone:310-376-9200
Mailing Address - Fax:310-376-9202
Practice Address - Street 1:210 N AVIATION BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-7015
Practice Address - Country:US
Practice Address - Phone:310-376-9200
Practice Address - Fax:310-376-9202
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT-13256225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT132560OtherBLUE SHIELD PIN
CA5135086OtherAETNA
CAOPT132560OtherBLUE SHIELD PIN
CAP00186060Medicare PIN