MEDICARE: MARIA L CORONADO

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	225X00000X	Occupational Therapist	5967	CA

General Provider Information

NPI Number	:	1760600829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA L CORONADO

Provider Business Mailing Address
First Line	:	28093 SMYTH DR
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-4023
Country	:	US
Telephone Number	:	661-295-0181
Fax Number	:

Provider Business Practice Location Address
First Line	:	28093 SMYTH DR
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-4023
Country	:	US
Telephone Number	:	661-295-0181
Fax Number	:

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

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	04/25/2013

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Directions to “ MARIA L CORONADO ” Practice Location

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