Provider Demographics
NPI:1144487810
Name:TANNER-HILL, ADAM (PT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:TANNER-HILL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5424
Mailing Address - Country:US
Mailing Address - Phone:310-275-2800
Mailing Address - Fax:310-275-2886
Practice Address - Street 1:9301 WILSHIRE BLVD
Practice Address - Street 2:SUITE 502
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5424
Practice Address - Country:US
Practice Address - Phone:310-275-2800
Practice Address - Fax:310-275-2886
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT18721225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist