MEDICARE: JAMIE TO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	309746	CA

General Provider Information

NPI Number	:	1003768821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE TO

Provider Business Mailing Address
First Line	:	2 N LAKE AVE # 500
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-1858
Country	:	US
Telephone Number	:	626-481-6499
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 N LAKE AVE # 500
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-1858
Country	:	US
Telephone Number	:	626-481-6499
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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Directions to “ JAMIE TO ” Practice Location

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