MEDICARE: TOPANGA TERRACE

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	283X00000X	Rehabilitation Hospital	OT12505	CA

General Provider Information

NPI Number	:	1164882015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOPANGA TERRACE

Provider Business Mailing Address
First Line	:	8426 NATALIE LN
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91304-3125
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8426 NATALIE LN
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91304-3125
Country	:	US
Telephone Number	:	818-307-3413
Fax Number	:

Authorized Official
Title or Position	:	OT
Name	:	VY HUYNH
Credential	:
Telephone Number	:	818-307-3413

Provider Enumeration Date	:	03/03/2016
Last Update Date	:	03/03/2016

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