MR. WYATT ROBERT WICHMAN
NPI 1265072904
Clinic/Center - Physical Therapy in Glendale, CA

Active since January 10, 2020
100 W BROADWAY STE 750, GLENDALE, CA 91210(323) 419-4103(323) 419-5507 Get Directions Write a Review

NPPES record last updated: January 14, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 14, 2020, Jan 10, 2020 (2 updates tracked since 2020).

About Mr. Wyatt Robert Wichman NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. WYATT ROBERT WICHMAN (NPI 1265072904) is an individual physical therapy provider in Glendale, California, licensed in California (03316548) and active in the NPI registry since January 2020.

NPPES Registry Identity

NPI1265072904
Entity TypeIndividualMale
Primary Taxonomy261QP2000X
Provider Legal NameMR. WYATT ROBERT WICHMAN
Location Address100 W BROADWAY STE 750Glendale, CA 91210-1215
Mailing Address100 W Broadway Ste 750Glendale, CA 91210-1215 · (323) 419-4103 · Fax (323) 419-5507
Fax(323) 419-5507
Sole ProprietorYes
Enumeration DateJanuary 10, 2020
Last NPPES UpdateJanuary 14, 20202 updates tracked since enumeration
NPI 1265072904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinic/Center · Physical TherapyAmbulatory Health Care Facilities
Taxonomy Code261QP2000X
License Licensed in CA · 03316548
Definition

An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.

Also ListedClinic/Center · Occupational MedicineTaxonomy 261QX0100X · License 03316548 (CA)
100 W BROADWAY STE 750, Glendale, CA 91210

Other Identifiers 1

Other03316548CA · Physical Therapy Agency

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
100 W BROADWAY STE 750
GLENDALE, CA 91210
Physical Therapist
100 W BROADWAY STE 750
GLENDALE, CA 91210

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wyatt Wichman's NPI number?

The NPI number for Wyatt Wichman is 1265072904. It was assigned to this individual provider in the NPPES registry on January 10, 2020.

Where is Wyatt Wichman located?

Wyatt Wichman practices at 100 W Broadway Ste 750, Glendale, CA 91210. The listed phone number is (323) 419-4103.

What is Wyatt Wichman's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Physical Therapy, with taxonomy code 261QP2000X.

When was this NPI record last updated?

The NPPES record for Wyatt Wichman was last updated on January 14, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.