Healthcare Provider Details

I. General information

NPI: 1518356831
Provider Name (Legal Business Name): PAULA AUERBACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 N EDINBURGH AVE
LOS ANGELES CA
90048-2308
US

IV. Provider business mailing address

434 N EDINBURGH AVE
LOS ANGELES CA
90048-2308
US

V. Phone/Fax

Practice location:
  • Phone: 323-655-2629
  • Fax:
Mailing address:
  • Phone: 323-655-2629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOTA 329
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: