Provider Demographics
NPI:1730755802
Name:MURO, ALICIA ORIAN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:ORIAN
Last Name:MURO
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 1:629 S AVE 60
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-4304
Mailing Address - Country:US
Mailing Address - Phone:323-316-0761
Mailing Address - Fax:
Practice Address - Street 1:629 S AVE 60
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-4304
Practice Address - Country:US
Practice Address - Phone:323-316-0761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-31
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300161261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy