Provider Demographics
NPI:1437472594
Name:GITMAN, SHARON (RPT)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:GITMAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10515 BALBOA BLVD.
Mailing Address - Street 2:SUITE 140
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344
Mailing Address - Country:US
Mailing Address - Phone:818-363-0339
Mailing Address - Fax:818-363-9915
Practice Address - Street 1:10515 BALBOA BLVD.
Practice Address - Street 2:SUITE 140
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344
Practice Address - Country:US
Practice Address - Phone:818-363-0339
Practice Address - Fax:818-363-9915
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT9721225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist