MEDICARE: MS. MICHELE LUCAS DELLINGER OTR/L, CHT

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	225X00000X	Occupational Therapist	OT7331	CA
2	225XE1200X	Ergonomics Occupational Therapist	7331	CA
3	225XH1200X	Hand Occupational Therapist	7331	CA

General Provider Information

NPI Number	:	1134456254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELE LUCAS DELLINGER OTR/L, CHT

Provider Business Mailing Address
First Line	:	1224 10TH ST STE 207
Second Line	:
City	:	CORONADO
State	:	CA
Zip	:	92118-3420
Country	:	US
Telephone Number	:	619-726-4931
Fax Number	:	858-412-3728

Provider Business Practice Location Address
First Line	:	1224 10TH ST STE 207
Second Line	:
City	:	CORONADO
State	:	CA
Zip	:	92118-3420
Country	:	US
Telephone Number	:	619-726-4931
Fax Number	:	858-412-3728

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

Provider Enumeration Date	:	11/10/2009
Last Update Date	:	10/06/2023

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