Provider Demographics
NPI:1013715051
Name:WEBER, ROMAN DUSTIN (DPT)
Entity type:Individual
Prefix:DR
First Name:ROMAN
Middle Name:DUSTIN
Last Name:WEBER
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E OLIVE AVE STE 325
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-3338
Mailing Address - Country:US
Mailing Address - Phone:818-955-5786
Mailing Address - Fax:818-955-5789
Practice Address - Street 1:500 E OLIVE AVE STE 325
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501-3338
Practice Address - Country:US
Practice Address - Phone:818-955-5789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT300054225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist