Healthcare Provider Details

I. General information

NPI: 1205034089
Provider Name (Legal Business Name): HANDS ONLY OT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HAMMOND STE C
IRVINE CA
92618-1680
US

IV. Provider business mailing address

24 HAMMOND STE C
IRVINE CA
92618-1680
US

V. Phone/Fax

Practice location:
  • Phone: 949-770-6022
  • Fax: 949-770-7084
Mailing address:
  • Phone: 949-770-6022
  • Fax: 949-770-7084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALBERTO MARCIANO
Title or Position: OWNER
Credential:
Phone: 949-770-6022