Healthcare Provider Details

I. General information

NPI: 1255596920
Provider Name (Legal Business Name): ALICE F BILLMAN MT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PACIFIC COAST HWY SUITE 207
SEAL BEACH CA
90740-5999
US

IV. Provider business mailing address

550 PACIFIC COAST HWY SUITE 207
SEAL BEACH CA
90740-5999
US

V. Phone/Fax

Practice location:
  • Phone: 562-708-1202
  • Fax: 562-683-0314
Mailing address:
  • Phone: 562-708-1202
  • Fax: 562-683-0314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: