Provider Demographics
NPI:1366564759
Name:YOU, MI Y (RPT)
Entity type:Individual
Prefix:MRS
First Name:MI
Middle Name:Y
Last Name:YOU
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:2727 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2699
Mailing Address - Country:US
Mailing Address - Phone:213-382-0088
Mailing Address - Fax:213-380-2038
Practice Address - Street 1:2727 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2699
Practice Address - Country:US
Practice Address - Phone:213-382-0088
Practice Address - Fax:213-380-2038
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT22291225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT22291AMedicare UPIN