Provider Demographics
NPI:1962618736
Name:VAN LANINGHAM, PAMELA (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:VAN LANINGHAM
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:1811 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5651
Mailing Address - Country:US
Mailing Address - Phone:310-829-3320
Mailing Address - Fax:310-829-3305
Practice Address - Street 1:1811 WILSHIRE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5651
Practice Address - Country:US
Practice Address - Phone:310-829-3320
Practice Address - Fax:310-829-3305
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2010-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPT23628225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist