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NPI Code Detail

MEDICARE: ROSEMARY FRAUSTO OTR/L

MEDICARE: ROSEMARY FRAUSTO OTR/L
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
1225X00000XOccupational Therapist23203CA

General Provider Information

NPI Number : 1174270532
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSEMARY FRAUSTO OTR/L
Provider Business Mailing Address
First Line : 542 SIMMONS AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-2732
Country : US
Telephone Number : 323-485-4629
Fax Number :
Provider Business Practice Location Address
First Line : 615 N NASH ST STE 306
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-2850
Country : US
Telephone Number : 310-535-0008
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2022
Last Update Date : 03/06/2022

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Directions to “ ROSEMARY FRAUSTO OTR/L” Practice Location

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