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General NPI Number Information
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NPI Number | 1366120743
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Entity Type | Individual
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Provider Name | TUPOU T LEGER
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Gender | Female
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Dates
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Enumeration Date | 07/06/2023
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 8525 S BROADWAY
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City | LOS ANGELES
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State | CA
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Zip | 90003-3334
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Country | US
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Telephone | 310-248-0240
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Fax |
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Provider Business Mailing Address
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Address Line | 1618 ALVIRA ST
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City | LOS ANGELES
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State | CA
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Zip | 90035-4518
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Country | US
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Telephone | 310-248-0240
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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