Provider Demographics
NPI:1881097574
Name:THOMSEN, ROBERT (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:THOMSEN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 N ORANGE DR APT 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7537
Mailing Address - Country:US
Mailing Address - Phone:434-989-2178
Mailing Address - Fax:
Practice Address - Street 1:1330 N ORANGE DR APT 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-7537
Practice Address - Country:US
Practice Address - Phone:434-989-2178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41776225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist