MEDICARE: ENJOLI PAGE FILEMU OTD, OTR/L, CPAM

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	10724	CA

General Provider Information

NPI Number	:	1154703189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ENJOLI PAGE FILEMU OTD, OTR/L, CPAM

Provider Business Mailing Address
First Line	:	16761 VIEWPOINT LN APT 3
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-4753
Country	:	US
Telephone Number	:	626-755-4412
Fax Number	:

Provider Business Practice Location Address
First Line	:	16761 VIEWPOINT LN APT 3
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-4753
Country	:	US
Telephone Number	:	626-755-4412
Fax Number	:

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

Provider Enumeration Date	:	06/25/2015
Last Update Date	:	06/25/2015

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