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NPI Code Detail

MEDICARE: LISA TODD OTR/L

MEDICARE:   LISA  TODD  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 Therapist12847CA

General Provider Information

NPI Number : 1487168837
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA TODD OTR/L
Provider Business Mailing Address
First Line : 249 TURF VIEW DR
Second Line :
City : SOLANA BEACH
State : CA
Zip : 92075-2316
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1615 S RANCHO SANTA FE RD STE A
Second Line :
City : SAN MARCOS
State : CA
Zip : 92078-5194
Country : US
Telephone Number : 337-344-7068
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2017
Last Update Date : 11/21/2017

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Directions to “ LISA TODD OTR/L” Practice Location

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