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NPI Code Detail

MEDICARE: MRS. SUSAN MAZMANIAN OTR/L

MEDICARE:  MRS. SUSAN  MAZMANIAN  OTR/L
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
1225X00000XOccupational Therapist6701CA

General Provider Information

NPI Number : 1265672786
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN MAZMANIAN OTR/L
Provider Business Mailing Address
First Line : 1623 STEINHART AVE
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90278-2747
Country : US
Telephone Number : 310-614-6439
Fax Number :
Provider Business Practice Location Address
First Line : 1623 STEINHART AVE
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90278-2747
Country : US
Telephone Number : 310-614-6439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2009
Last Update Date : 02/24/2009

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Directions to “ MRS. SUSAN MAZMANIAN OTR/L” Practice Location

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