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General NPI Number Information
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NPI Number | 1649475906
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Entity Type | Individual
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Provider Name | KARILYNN MIYOKO MORIYAMA PT, ATC
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 12801 CROSSROADS PKWY S
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91746-3412
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Country | US
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Telephone | 562-463-4337
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Fax | 562-463-4343
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Provider Business Mailing Address
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Address Line | 1604 AMELUXEN AVE
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-2505
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Country | US
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Telephone | 626-330-1824
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT19016
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License Number State | CA
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