MEDICARE: GAYON K AUGUSTINE

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	225700000X	Massage Therapist	73346	CA

General Provider Information

NPI Number	:	1881418895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAYON K AUGUSTINE

Provider Business Mailing Address
First Line	:	222 E DEL MAR BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-2771
Country	:	US
Telephone Number	:	310-946-9889
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 E DEL MAR BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-2771
Country	:	US
Telephone Number	:	310-946-9889
Fax Number	:

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

Provider Enumeration Date	:	11/14/2024
Last Update Date	:	11/14/2024

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Directions to “ GAYON K AUGUSTINE ” Practice Location

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