Provider Demographics
NPI:1881788305
Name:SYLVIA A MEHL PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:SYLVIA A MEHL PHYSICAL THERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MEHL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS
Authorized Official - Phone:310-376-9200
Mailing Address - Street 1:210 N. AVIATION BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-7015
Mailing Address - Country:US
Mailing Address - Phone:310-376-9200
Mailing Address - Fax:310-376-9202
Practice Address - Street 1:210 N. AVIATION BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-7015
Practice Address - Country:US
Practice Address - Phone:310-376-9200
Practice Address - Fax:310-376-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT13256225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5529290OtherCCN IDENTIFICATION NUMBER
CA2217535OtherFIRST HEALTH ID #
CA90999OtherPHCS GROUP ID
CA5135086OtherAETNA PIN
CAZZZ08716ZOtherBS GROUP ID
CA5529290OtherCCN IDENTIFICATION NUMBER
CA2217535OtherFIRST HEALTH ID #