MEDICARE: MR. LAWRENCE JAY ZIPSER P.T.

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	PT7232	CA

General Provider Information

NPI Number	:	1043299092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAWRENCE JAY ZIPSER P.T.

Provider Business Mailing Address
First Line	:	8212 MALLOY DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-5018
Country	:	US
Telephone Number	:	714-969-2924
Fax Number	:	714-969-6023

Provider Business Practice Location Address
First Line	:	3816 WOODRUFF AVE
Second Line	:	#407
City	:	LONG BEACH
State	:	CA
Zip	:	90808
Country	:	US
Telephone Number	:	562-425-9888
Fax Number	:	562-425-9505

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	07/19/2010

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