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NPI Code Detail

MEDICARE: MR. BILLY STIMSON MA

MEDICARE:  MR. BILLY  STIMSON  MA
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
1225XP0200XPediatric Occupational Therapist1179CA

General Provider Information

NPI Number : 1114081940
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BILLY STIMSON MA
Provider Business Mailing Address
First Line : 2500 PACIFIC AVE
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-2336
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 150 SIERRA ST
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-4117
Country : US
Telephone Number : 310-426-9406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 07/08/2007

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Directions to “ MR. BILLY STIMSON MA” Practice Location

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