Healthcare Provider Details

I. General information

NPI: 1679338214
Provider Name (Legal Business Name): LOISE ANGELICA ALMIROL ELORDE COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17042 BELLFLOWER BLVD
BELLFLOWER CA
90706-5950
US

IV. Provider business mailing address

817 W BEVERLY BLVD STE 201
MONTEBELLO CA
90640-4265
US

V. Phone/Fax

Practice location:
  • Phone: 562-991-1324
  • Fax:
Mailing address:
  • Phone: 562-927-5820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA6403
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: