Basic Information
| Provider Information | |||||||||
| NPI: | 1114256278 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | DINA | ||||||||
| MiddleName: | COHAN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4502 IRVINE AVE | ||||||||
| Address2: | |||||||||
| City: | STUDIO CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 916021916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8186360979 | ||||||||
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| Practice Location | |||||||||
| Address1: | 26560 AGOURA RD | ||||||||
| Address2: | SUITE 110-B | ||||||||
| City: | CALABASAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913021926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188801260 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2009 | ||||||||
| LastUpdateDate: | 12/18/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT23119 | CA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2251P0200X | PT23119 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | CGP170897 | 01 | CA | CGP NUMBER | OTHER |