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General NPI Number Information
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NPI Number | 1972079457
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Entity Type | Individual
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Provider Name | MANOJ K PARIDA OTR/L
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Gender | Male
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 350 NUGGET CT
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City | SAN DIMAS
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State | CA
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Zip | 91773-2312
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Country | US
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Telephone | 818-314-5774
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Fax |
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Provider Business Mailing Address
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Address Line | 350 NUGGET CT
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City | SAN DIMAS
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State | CA
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Zip | 91773-2312
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Country | US
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Telephone | 818-314-5774
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Fax | 818-484-2146
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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 | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | OT817
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225XH1300X
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Taxonomy Name | Human Factors Occupational Therapist
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License Number | OT817
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT817
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License Number State | CA
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