Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ca Fidelis PC

Organization Physical Medicine & Rehabilitation Physician · NPI 1427325109

Ca Fidelis PC is a Physical Medicine & Rehabilitation Physician in Los Angeles, California. Licensed in California. Registered with an NPI since 2011.

Licensed in
CA
In the registry since
2011
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11726 San Vicente Blvd Ste 414
Los Angeles, CA 90049-5044
Phone: (877) 408-2488
Fax: (866) 776-6641
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence G75477 (CA)

Record details

NPI number1427325109
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Glen Halvorson — Medical Director · (877) 408-2488
NPI enumeratedNovember 22, 2011
Last updated in NPPESMarch 27, 2012
Mailing address11726 San Vicente Blvd, Suite 414, Los Angeles, CA 90049-5044

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