MEDICARE: ANITA CHRISTINE NELMS 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
1	225X00000X	Occupational Therapist	OT1516	CA

General Provider Information

NPI Number	:	1376797605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA CHRISTINE NELMS OTR/L

Provider Business Mailing Address
First Line	:	5254 THORNBURN ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-2258
Country	:	US
Telephone Number	:	310-437-3485
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 W CENTINELA AVE
Second Line	:	SUITE 150
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6337
Country	:	US
Telephone Number	:	310-998-1970
Fax Number	:	310-988-1980

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

Provider Enumeration Date	:	11/13/2008
Last Update Date	:	11/09/2011

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