Provider Demographics
NPI:1104581685
Name:RAPHA HOUSE PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:RAPHA HOUSE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:SONDREAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:747-200-5653
Mailing Address - Street 1:16350 VENTURA BLVD STE D-160
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-5300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16632 HAYNES ST
Practice Address - Street 2:
Practice Address - City:LAKE BALBOA
Practice Address - State:CA
Practice Address - Zip Code:91406-5619
Practice Address - Country:US
Practice Address - Phone:747-200-5653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy