Provider Demographics
NPI:1497411573
Name:MAKAREMI, ARDAVAN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ARDAVAN
Middle Name:
Last Name:MAKAREMI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 N 4TH ST STE 208
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4309
Mailing Address - Country:US
Mailing Address - Phone:323-246-4616
Mailing Address - Fax:213-724-0277
Practice Address - Street 1:433 N 4TH ST STE 208
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4309
Practice Address - Country:US
Practice Address - Phone:323-246-4616
Practice Address - Fax:213-724-0277
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist