Provider Demographics
NPI:1063575090
Name:ESHLEMAN, TYLER F (MSPT)
Entity type:Individual
Prefix:MR
First Name:TYLER
Middle Name:F
Last Name:ESHLEMAN
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N FIRST ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1845
Mailing Address - Country:US
Mailing Address - Phone:818-846-7100
Mailing Address - Fax:818-846-7101
Practice Address - Street 1:100 N FIRST ST
Practice Address - Street 2:SUITE 103
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1845
Practice Address - Country:US
Practice Address - Phone:818-846-7100
Practice Address - Fax:818-846-7101
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0250941208100000X
CA40092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7071440OtherAETNA
NY10062514OtherCDPHP
NY7071440OtherAETNA