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General NPI Number Information
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NPI Number | 1699218743
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Entity Type | Individual
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Provider Name | MIGUEL LALOTA
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Gender | Male
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Dates
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Enumeration Date | 11/22/2016
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 1515 N ALEXANDRIA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90027-5203
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Country | US
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Telephone | 323-600-4268
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Fax |
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Provider Business Mailing Address
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Address Line | 225 W ASH AVE
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City | BURBANK
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State | CA
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Zip | 91502-2402
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA3678
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License Number State | CA
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