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NPI Code Detail

MEDICARE: CELESTE GRACIA NORA

MEDICARE: CELESTE GRACIA NORA
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
1225100000XPhysical Therapist29673CA

General Provider Information

NPI Number : 1306483326
Entity Type Code : Individual
Provider Name (Legal Business Name) : CELESTE GRACIA NORA
Provider Business Mailing Address
First Line : 10024 RUTLEDGE PL
Second Line :
City : SUN VALLEY
State : CA
Zip : 91352-4251
Country : US
Telephone Number : 818-357-3368
Fax Number :
Provider Business Practice Location Address
First Line : 2221 LINCOLN PARK AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-2920
Country : US
Telephone Number : 323-276-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2019
Last Update Date : 12/09/2019

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Directions to “ CELESTE GRACIA NORA ” Practice Location

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