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General NPI Number Information
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NPI Number | 1144507914
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Entity Type | Individual
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Provider Name | EVELYN MACHAN ANDAMO O.T.
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Gender | Female
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 11391 ACACIA PKWY
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City | GARDEN GROVE
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State | CA
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Zip | 92840-5310
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Country | US
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Telephone | 714-530-1566
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Fax |
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Provider Business Mailing Address
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Address Line | 9761 OLYMPIC DR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-4846
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Country | US
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Telephone | 714-883-4046
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Fax | 714-963-5375
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT 665
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License Number State | CA
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