Provider Demographics
NPI:1982155289
Name:PIMENTEL, NERMAN (PTA)
Entity Type:Individual
Prefix:MR
First Name:NERMAN
Middle Name:
Last Name:PIMENTEL
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8510 BALBOA BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-3583
Mailing Address - Country:US
Mailing Address - Phone:818-637-2000
Mailing Address - Fax:818-654-3417
Practice Address - Street 1:12100 VALLEY BLVD STE 109A
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-3161
Practice Address - Country:US
Practice Address - Phone:626-575-7500
Practice Address - Fax:626-575-1956
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT10385225200000X
CA299595225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant