Provider Demographics
NPI:1770788978
Name:FONES, MORGAN LYMAN (DPT, ATC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LYMAN
Last Name:FONES
Suffix:
Gender:M
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1640 MARENGO ST
Mailing Address - Street 2:HRA 102
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1036
Mailing Address - Country:US
Mailing Address - Phone:323-224-7070
Mailing Address - Fax:323-224-7075
Practice Address - Street 1:1640 MARENGO ST
Practice Address - Street 2:HRA 102
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1036
Practice Address - Country:US
Practice Address - Phone:323-224-7070
Practice Address - Fax:323-224-7075
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA0604027042255A2300X
CAPT329462251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer