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General NPI Number Information
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NPI Number | 1962227355
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Entity Type | Individual
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Provider Name | MIRANDA JUSTINE TRAMISON DPT, PT
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Gender | Female
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 5455 GARDEN GROVE BLVD STE 100
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City | WESTMINSTER
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State | CA
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Zip | 92683-8201
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Country | US
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Telephone | 866-303-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 1613 ROCK RIV
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City | PLACENTIA
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State | CA
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Zip | 92870-2626
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Country | US
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Telephone | 714-203-4508
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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 | 307210
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License Number State | CA
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