MEDICARE: MR. HORACIO ARIEL VELA JR.

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	225XG0600X	Gerontology Occupational Therapist	18815	CA

General Provider Information

NPI Number	:	1700683372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HORACIO ARIEL VELA JR.

Provider Business Mailing Address
First Line	:	5130 KLUMP AVE # K216
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-5048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5130 KLUMP AVE # K216
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-5048
Country	:	US
Telephone Number	:	956-740-5799
Fax Number	:

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

Provider Enumeration Date	:	02/28/2025
Last Update Date	:	02/28/2025

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