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NPI Code Detail

MEDICARE: MICHAEL VAYNTRUB OTR/L

MEDICARE: MICHAEL VAYNTRUB 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
1225X00000XOccupational Therapist22431CA

General Provider Information

NPI Number : 1558004036
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL VAYNTRUB OTR/L
Provider Business Mailing Address
First Line : 7849 OCEANUS DR
Second Line :
City : LOS ANGELES
State : CA
Zip : 90046-2042
Country : US
Telephone Number : 310-909-3817
Fax Number :
Provider Business Practice Location Address
First Line : 5417 PACER VALLEY CT
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93313-4304
Country : US
Telephone Number : 661-654-6559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2022
Last Update Date : 04/14/2022

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