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General NPI Number Information
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NPI Number | 1770374795
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Entity Type | Individual
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Provider Name | MARIA NUCUM OTR
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Gender | Female
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 5801 CRESTRIDGE RD
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-4964
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Country | US
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Telephone | 877-727-3213
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Fax |
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Provider Business Mailing Address
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Address Line | 76 VIA DEL CIELO
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-2510
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Country | US
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Telephone | 714-206-7597
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2730
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License Number State | CA
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