MEDICARE: GALEN M OKAZAKI PT

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	PT28515	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT28515	OTHER	CA	PT LICENSE

General Provider Information

NPI Number	:	1306152392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GALEN M OKAZAKI PT

Provider Business Mailing Address
First Line	:	1748 SINALOA RD
Second Line	:	#258
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-3071
Country	:	US
Telephone Number	:	818-730-2994
Fax Number	:

Provider Business Practice Location Address
First Line	:	1748 SINALOA RD
Second Line	:	#258
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-3071
Country	:	US
Telephone Number	:	818-730-2994
Fax Number	:

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

Provider Enumeration Date	:	08/27/2010
Last Update Date	:	08/27/2010

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Directions to “ GALEN M OKAZAKI PT” Practice Location

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