MEDICARE: VALERIE E PLUMMER OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	OT 5207	CA

General Provider Information

NPI Number	:	1053338616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE E PLUMMER OTR

Provider Business Mailing Address
First Line	:	5329 TRIANA ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-3248
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7927 OSTROW ST STE B
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-3604
Country	:	US
Telephone Number	:	858-565-6910
Fax Number	:	858-565-6911

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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