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General NPI Number Information
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NPI Number | 1225460553
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Entity Type | Individual
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Provider Name | MARIA VISTA RAMON RPT
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Gender | Female
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 3055 WILSHIRE BLVD. STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90010-1119
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Country | US
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Telephone | 213-383-0008
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Fax | 213-389-0390
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Provider Business Mailing Address
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Address Line | 3055 WILSHIRE BLVD. STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90010-1119
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Country | US
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Telephone | 213-383-0008
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Fax | 213-389-0390
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 18720
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License Number State | CA
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