Provider Demographics
NPI:1134833320
Name:CHELEPYAN, MICHELLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:CHELEPYAN
Suffix:
Gender:F
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 1:903 E ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-1531
Mailing Address - Country:US
Mailing Address - Phone:818-636-3907
Mailing Address - Fax:
Practice Address - Street 1:2001 W ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2932
Practice Address - Country:US
Practice Address - Phone:818-953-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303281225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty