Provider Demographics
NPI:1912368358
Name:BVM THERAPY INC.
Entity Type:Organization
Organization Name:BVM THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED SIGNATORY
Authorized Official - Prefix:DR
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DARVISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-826-2555
Mailing Address - Street 1:11611 SAN VICENTE BLVD
Mailing Address - Street 2:#GF1
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5106
Mailing Address - Country:US
Mailing Address - Phone:310-820-0013
Mailing Address - Fax:310-207-2630
Practice Address - Street 1:11611 SAN VICENTE BLVD
Practice Address - Street 2:#GF1
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-5106
Practice Address - Country:US
Practice Address - Phone:310-820-0013
Practice Address - Fax:310-207-2630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-13
Last Update Date:2016-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92794261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy