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NPI Code Detail

MEDICARE: MR. VICTOR FUJII COTA

MEDICARE: MR. VICTOR FUJII COTA
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
1224Z00000XOccupational Therapy Assistant569CA

General Provider Information

NPI Number : 1457311136
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VICTOR FUJII COTA
Provider Business Mailing Address
First Line : 22609 MOSSY ROCK DR
Second Line :
City : HAYWARD
State : CA
Zip : 94541-3428
Country : US
Telephone Number : 510-881-4600
Fax Number :
Provider Business Practice Location Address
First Line : 629 OAKLAND AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94611-4567
Country : US
Telephone Number : 510-658-9480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2006
Last Update Date : 07/08/2007

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