Provider Demographics
NPI:1952507246
Name:AMINTOWLIEH, ORANG (MS)
Entity Type:Individual
Prefix:MR
First Name:ORANG
Middle Name:
Last Name:AMINTOWLIEH
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 SANTA LUCIA DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-4215
Mailing Address - Country:US
Mailing Address - Phone:818-462-3704
Mailing Address - Fax:
Practice Address - Street 1:4610 SANTA LUCIA DR
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-4215
Practice Address - Country:US
Practice Address - Phone:818-462-3704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-23
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28252225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist