Doctor Name: | DARWIN LANCE FOGT |
NPI Number: | 1295782894 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT |
License Number: | PT26595 |
Business Practice Address: | 11825 Major St Culver City, CA - 902306356 |
Business Phone Number: | 3109156100 |
Business Fax Number: | 3109150100 |
Mailing Address: | 322 Culver Blvd, PLAYA DEL REY |
State: | CA |
Postal Code: | 902937784 |
Phone Number: | 3109156100 |
Fax Number: | 3109150100 |
NPI Enumeration Date: | 05/28/2006 |
NPI Last Update Date: | 11/30/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT26595 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |