MEDICARE: CRIZZA ANNE CRUZ

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	225100000X	Physical Therapist	304002	CA

General Provider Information

NPI Number	:	1194503250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRIZZA ANNE CRUZ

Provider Business Mailing Address
First Line	:	6104 DREXEL AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-3139
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1711 W TEMPLE ST STE 2052
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-7329
Country	:	US
Telephone Number	:	213-814-4020
Fax Number	:	213-483-1733

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

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	10/25/2024

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