MEDICARE: ALLISON ANG

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	225X00000X	Occupational Therapist	OTA3620	CA

General Provider Information

NPI Number	:	1073016374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON ANG

Provider Business Mailing Address
First Line	:	140 E SPRING ST APT 11
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1529
Country	:	US
Telephone Number	:	310-421-5757
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 E SPRING ST APT 11
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1529
Country	:	US
Telephone Number	:	310-421-5757
Fax Number	:

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

Provider Enumeration Date	:	03/13/2018
Last Update Date	:	03/13/2018

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Directions to “ ALLISON ANG ” Practice Location

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