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NPI Code Detail

MEDICARE: MS. CHRISTINE CAROLYN POWELL P.T., M.ED.

MEDICARE: MS. CHRISTINE CAROLYN POWELL P.T., M.ED.
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
1225100000XPhysical TherapistPT16191CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11518182930OTHERCANPI

General Provider Information

NPI Number : 1518182930
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINE CAROLYN POWELL P.T., M.ED.
Provider Business Mailing Address
First Line : PO BOX 7221
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92658-7221
Country : US
Telephone Number : 949-597-0007
Fax Number :
Provider Business Practice Location Address
First Line : 23521 PASEO DE VALENCIA 210
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-3140
Country : US
Telephone Number : 949-597-0007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2007
Last Update Date : 12/31/2016

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