Healthcare Provider Details

I. General information

NPI: 1043621345
Provider Name (Legal Business Name): MARIA ANGELI LLAMZON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 05/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 W 207TH ST UNIT D
TORRANCE CA
90501-6432
US

IV. Provider business mailing address

1514 W 207TH ST UNIT D
TORRANCE CA
90501-6432
US

V. Phone/Fax

Practice location:
  • Phone: 310-869-7545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number5924
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: