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NPI Code Detail

MEDICARE: LINDA PITTMAN

MEDICARE: LINDA PITTMAN
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
1225XG0600XGerontology Occupational Therapist10122CA

General Provider Information

NPI Number : 1093103228
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA PITTMAN
Provider Business Mailing Address
First Line : 3401 CEDAR AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-4422
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3401 CEDAR AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-4422
Country : US
Telephone Number : 310-488-8390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2014
Last Update Date : 12/22/2014

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Directions to “ LINDA PITTMAN ” Practice Location

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