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General NPI Number Information
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NPI Number | 1609093269
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Entity Type | Individual
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Provider Name | JILL MURCH C.O.T.A.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 01/26/2009
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Provider Practice Location Address
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Address Line | 802 MAGNOLIA AVE STE106
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City | CORONA
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State | CA
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Zip | 92879-3104
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Country | US
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Telephone | 951-734-0134
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Fax | 951-734-0724
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Provider Business Mailing Address
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Address Line | 101 S KRAEMER BLVD STE. 206
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City | PLACENTIA
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State | CA
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Zip | 92870-6105
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Country | US
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Telephone | 714-961-8288
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Fax | 714-524-3753
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | OTA536
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License Number State | CA
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