Provider Demographics
NPI:1801433651
Name:DADAIAN, HAIG JOHN (DPT)
Entity type:Individual
Prefix:
First Name:HAIG
Middle Name:JOHN
Last Name:DADAIAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3379 ALGINET DR
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4121
Mailing Address - Country:US
Mailing Address - Phone:818-644-3460
Mailing Address - Fax:
Practice Address - Street 1:18411 CLARK ST STE 302
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3541
Practice Address - Country:US
Practice Address - Phone:818-501-7276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-27
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1418878222251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports