Provider Demographics
NPI:1356963359
Name:ALTURK, DINA MOHAMADJALAL (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:MOHAMADJALAL
Last Name:ALTURK
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 RUBERTA AVE APT B
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-3648
Mailing Address - Country:US
Mailing Address - Phone:619-721-8203
Mailing Address - Fax:
Practice Address - Street 1:1049 RUBERTA AVE APT B
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-3648
Practice Address - Country:US
Practice Address - Phone:619-721-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty