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NPI Code Detail

MEDICARE: ANDREA H LIMB P.T.

MEDICARE: ANDREA H LIMB P.T.
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 TherapistPT22856CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ16603ZOTHERCAMEDICARE GROUP PTAN

General Provider Information

NPI Number : 1568446953
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA H LIMB P.T.
Provider Business Mailing Address
First Line : 2500 MERCED ST
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94577-4201
Country : US
Telephone Number : 510-454-1000
Fax Number : 510-351-6906
Provider Business Practice Location Address
First Line : 2500 MERCED ST
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94577-4201
Country : US
Telephone Number : 510-454-1000
Fax Number : 510-351-6906
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 02/11/2022

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