Provider Demographics
NPI:1306995964
Name:MOLNAR, LAURA (MPT)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:MOLNAR
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10880 WILSHIRE BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4102
Mailing Address - Country:US
Mailing Address - Phone:323-481-0644
Mailing Address - Fax:323-755-8026
Practice Address - Street 1:10880 WILSHIRE BLVD STE 112
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4102
Practice Address - Country:US
Practice Address - Phone:323-481-0644
Practice Address - Fax:323-755-8026
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT26122AMedicare ID - Type Unspecified
CAQ64929Medicare UPIN