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NPI Code Detail

MEDICARE: LEN LOVALLO

MEDICARE: LEN LOVALLO
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1386841062
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEN LOVALLO
Provider Business Mailing Address
First Line : 1328 2ND ST
Second Line :
City : SANTA MONICA
State : CA
Zip : 90401-1122
Country : US
Telephone Number : 818-294-0482
Fax Number :
Provider Business Practice Location Address
First Line : 1328 2ND ST
Second Line :
City : SANTA MONICA
State : CA
Zip : 90401-1122
Country : US
Telephone Number : 310-420-5653
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2007
Last Update Date : 06/13/2013

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Directions to “ LEN LOVALLO ” Practice Location

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