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NPI Code Detail

MEDICARE: JOSEF NOAH J DIZON OTR/L

MEDICARE: JOSEF NOAH J DIZON OTR/L
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
1225X00000XOccupational Therapist24131CA

General Provider Information

NPI Number : 1417790320
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEF NOAH J DIZON OTR/L
Provider Business Mailing Address
First Line : 228 W POMONA AVE
Second Line :
City : MONROVIA
State : CA
Zip : 91016-4790
Country : US
Telephone Number : 747-273-6473
Fax Number :
Provider Business Practice Location Address
First Line : 777 BANNOCK ST
Second Line :
City : DENVER
State : CO
Zip : 80204-4597
Country : US
Telephone Number : 303-436-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2024
Last Update Date : 12/15/2025

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