Provider Demographics
NPI:1366935892
Name:SCOTT, CHRIS (PT, DPT)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:GORDON
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:4295 VIA ARBOLADA UNIT 103
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-5105
Mailing Address - Country:US
Mailing Address - Phone:213-247-1214
Mailing Address - Fax:
Practice Address - Street 1:4295 VIA ARBOLADA #103
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042
Practice Address - Country:US
Practice Address - Phone:213-247-1214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-09
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294788225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist