Healthcare Provider Details

I. General information

NPI: 1588030126
Provider Name (Legal Business Name): ELAINE KOJIMA CHIU OTD, OTR /L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2015
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1962 PLAZA DEL AMO APT A
TORRANCE CA
90501-4447
US

IV. Provider business mailing address

1962 PLAZA DEL AMO APT A
TORRANCE CA
90501-4447
US

V. Phone/Fax

Practice location:
  • Phone: 650-690-2325
  • Fax:
Mailing address:
  • Phone: 650-690-2325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT1301
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: