Provider Demographics
NPI:1336985779
Name:MOJAB, NELLIE (DPT)
Entity type:Individual
Prefix:DR
First Name:NELLIE
Middle Name:
Last Name:MOJAB
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24134 MENTRY DR
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-3947
Mailing Address - Country:US
Mailing Address - Phone:818-267-4297
Mailing Address - Fax:
Practice Address - Street 1:24134 MENTRY DR
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-3947
Practice Address - Country:US
Practice Address - Phone:818-267-4297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-04
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist