Provider Demographics
NPI:1285939546
Name:SORKIN, PHILIP MICHAEL (CRT, RRT-NPS, RCP)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:MICHAEL
Last Name:SORKIN
Suffix:
Gender:M
Credentials:CRT, RRT-NPS, RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21417 STANWELL ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2253
Mailing Address - Country:US
Mailing Address - Phone:818-257-4574
Mailing Address - Fax:
Practice Address - Street 1:21417 STANWELL ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2253
Practice Address - Country:US
Practice Address - Phone:818-257-4574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARCP 82012279P3900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P3900XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredNeonatal/Pediatrics