MEDICARE: JEFFREY TELMO COTA

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	224Z00000X	Occupational Therapy Assistant	2383	CA

General Provider Information

NPI Number	:	1336487867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY TELMO COTA

Provider Business Mailing Address
First Line	:	3412 TOLAS CT
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-3166
Country	:	US
Telephone Number	:	619-274-7569
Fax Number	:

Provider Business Practice Location Address
First Line	:	3412 TOLAS CT
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-3166
Country	:	US
Telephone Number	:	619-274-7569
Fax Number	:

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

Provider Enumeration Date	:	01/17/2013
Last Update Date	:	01/17/2013

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Directions to “ JEFFREY TELMO COTA” Practice Location

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