MEDICARE: JOSEPH JEMERA MPT

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
1	225100000X	Physical Therapist	39549	CA

General Provider Information

NPI Number	:	1669712246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH JEMERA MPT

Provider Business Mailing Address
First Line	:	PO BOX 955
Second Line	:
City	:	RANCHO MURIETA
State	:	CA
Zip	:	95683-0955
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7281 LONE PINE DR
Second Line	:	SUITE D103
City	:	RANCHO MURIETA
State	:	CA
Zip	:	95683-9715
Country	:	US
Telephone Number	:	916-354-0719
Fax Number	:	916-354-1187

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2013
Last Update Date	:	01/03/2022

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