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NPI Code Detail

MEDICARE: MRS. KRISTEN CAROL PITTS PT

MEDICARE: MRS. KRISTEN CAROL PITTS 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
1174400000XSpecialist18655CA

General Provider Information

NPI Number : 1407013162
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTEN CAROL PITTS PT
Provider Business Mailing Address
First Line : 15701 ROCKFIELD BLVD
Second Line :
City : IRVINE
State : CA
Zip : 92618-2801
Country : US
Telephone Number : 949-457-9900
Fax Number : 949-457-9922
Provider Business Practice Location Address
First Line : 15701 ROCKFIELD BLVD
Second Line :
City : IRVINE
State : CA
Zip : 92618-2801
Country : US
Telephone Number : 949-457-9900
Fax Number : 949-457-9922
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2008
Last Update Date : 05/20/2008

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