Provider Demographics
NPI:1356583405
Name:NELSON, PAMELA ANN (PT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:NELSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1601 N SEPULVEDA BLVD
Mailing Address - Street 2:SUITE #144
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5111
Mailing Address - Country:US
Mailing Address - Phone:310-543-9333
Mailing Address - Fax:310-405-0954
Practice Address - Street 1:3858 W CARSON ST
Practice Address - Street 2:SUITE 121
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6709
Practice Address - Country:US
Practice Address - Phone:310-543-9333
Practice Address - Fax:310-405-0954
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2013-04-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPT18539225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist