MEDICARE: MS. NATALY TARYN PLUTA PT

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	PT15109	CA

General Provider Information

NPI Number	:	1194748087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NATALY TARYN PLUTA PT

Provider Business Mailing Address
First Line	:	312 S CEDROS AVE
Second Line	:	206
City	:	SOLANA BEACH
State	:	CA
Zip	:	92075-1979
Country	:	US
Telephone Number	:	619-787-2729
Fax Number	:	858-350-1017

Provider Business Practice Location Address
First Line	:	312 S CEDROS AVE
Second Line	:	#206
City	:	SOLANA BEACH
State	:	CA
Zip	:	92075-1979
Country	:	US
Telephone Number	:	619-787-2729
Fax Number	:	858-350-1017

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	11/29/2011

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