MEDICARE: YOLANDA OSORIO DPT

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	PT37992	CA

General Provider Information

NPI Number	:	1992088496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA OSORIO DPT

Provider Business Mailing Address
First Line	:	29650 BRADLEY RD
Second Line	:
City	:	MENIFEE
State	:	CA
Zip	:	92586-6521
Country	:	US
Telephone Number	:	951-672-0455
Fax Number	:

Provider Business Practice Location Address
First Line	:	29650 BRADLEY RD
Second Line	:
City	:	MENIFEE
State	:	CA
Zip	:	92586-6521
Country	:	US
Telephone Number	:	951-672-0455
Fax Number	:

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

Provider Enumeration Date	:	09/21/2011
Last Update Date	:	09/21/2011

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