MEDICARE: JULIE SIAS

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	225100000X	Physical Therapist	295927	CA

General Provider Information

NPI Number	:	1053883454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE SIAS

Provider Business Mailing Address
First Line	:	2518 SALERNO
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-3263
Country	:	US
Telephone Number	:	714-717-4700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2518 SALERNO
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-3263
Country	:	US
Telephone Number	:	714-331-4145
Fax Number	:

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

Provider Enumeration Date	:	12/23/2018
Last Update Date	:	09/17/2019

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Directions to “ JULIE SIAS ” Practice Location

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