MEDICARE: MR. PATRICK LOSASSO CSCS, CPT

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	174400000X	Specialist	T67767	CA

General Provider Information

NPI Number	:	1841589181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PATRICK LOSASSO CSCS, CPT

Provider Business Mailing Address
First Line	:	1167 MONTECITO DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-1651
Country	:	US
Telephone Number	:	323-422-9794
Fax Number	:	323-222-6952

Provider Business Practice Location Address
First Line	:	1167 MONTECITO DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-1651
Country	:	US
Telephone Number	:	323-422-9794
Fax Number	:	323-222-6952

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

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	04/06/2011

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