MEDICARE: SABRINA HIRAMOTO

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1265795652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRINA HIRAMOTO

Provider Business Mailing Address
First Line	:	4650 WEST OAKEY BOULEVARD
Second Line	:	APT 1001
City	:	LAS VEGAS
State	:	NV
Zip	:	89102
Country	:	US
Telephone Number	:	310-339-4884
Fax Number	:	877-533-6140

Provider Business Practice Location Address
First Line	:	4650 W OAKEY BLVD
Second Line	:	APT 1001
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1510
Country	:	US
Telephone Number	:	310-339-4884
Fax Number	:	877-533-6140

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

Provider Enumeration Date	:	06/20/2012
Last Update Date	:	06/20/2012

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Directions to “ SABRINA HIRAMOTO ” Practice Location

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