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NPI Code Detail

MEDICARE: JANELLE CARTER

MEDICARE: JANELLE CARTER
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1194197897
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANELLE CARTER
Provider Business Mailing Address
First Line : 1000 CORPORATE CENTER DR
Second Line : #650
City : MONTEREY PARK
State : CA
Zip : 91754-7600
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 605 N PARK AVE
Second Line : #9
City : POMONA
State : CA
Zip : 91768-3622
Country : US
Telephone Number : 626-861-3161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2015
Last Update Date : 10/21/2015

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Directions to “ JANELLE CARTER ” Practice Location

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