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

Skyfall Physical Therapy

Organization Physical Therapist · NPI 1982126728

Skyfall Physical Therapy is a Physical Therapist in Los Angeles, California. Registered with an NPI since 2017.

In the registry since
2017

Practice location Address checks out

11677 San Vicente Blvd Ste 207
Los Angeles, CA 90049-5128
Phone: (310) 743-6649
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1982126728
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Theresa Ketterhagen — President · (310) 743-6649
NPI enumeratedJuly 13, 2017
Last updated in NPPESApril 16, 2021
Certification dateApril 16, 2021
Mailing addressPo Box 491471, Los Angeles, CA 90049-9471

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