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NPI Code Detail

MEDICARE: LORI MICHI GINOZA D.P.T.

MEDICARE: LORI MICHI GINOZA D.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
12251N0400XNeurology Physical Therapist32984CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
132984OTHERCAPT LICENSE

General Provider Information

NPI Number : 1144425398
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI MICHI GINOZA D.P.T.
Provider Business Mailing Address
First Line : PO BOX 31309
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-0309
Country : US
Telephone Number : 323-865-1200
Fax Number :
Provider Business Practice Location Address
First Line : 1640 MARENGO ST STE 102
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1061
Country : US
Telephone Number : 323-865-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2007
Last Update Date : 11/27/2023

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