MEDICARE: MRS. BEATRIZ SHILTS 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
1	225XN1300X	Neurorehabilitation Occupational Therapist	8403	CA

General Provider Information

NPI Number	:	1477633683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BEATRIZ SHILTS OTR/L

Provider Business Mailing Address
First Line	:	10911 VIA BANCO
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-7411
Country	:	US
Telephone Number	:	858-232-9800
Fax Number	:

Provider Business Practice Location Address
First Line	:	10911 VIA BANCO
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-7411
Country	:	US
Telephone Number	:	858-232-9800
Fax Number	:

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/08/2007

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