MEDICARE: MARCIA PINTO

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	225700000X	Massage Therapist	4956	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4956	OTHER	CA	CALIFORNIA MASSAGE THERAPY COUNCIL

General Provider Information

NPI Number	:	1427396225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA PINTO

Provider Business Mailing Address
First Line	:	3622 KEYSTONE AVE APT 8
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-5691
Country	:	US
Telephone Number	:	805-636-8184
Fax Number	:

Provider Business Practice Location Address
First Line	:	3622 KEYSTONE AVE APT 8
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-5691
Country	:	US
Telephone Number	:	805-636-8184
Fax Number	:

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

Provider Enumeration Date	:	01/29/2013
Last Update Date	:	01/29/2013

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Directions to “ MARCIA PINTO ” Practice Location

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