MEDICARE: DONISHA CORTESE HALE

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	9748	CA

General Provider Information

NPI Number	:	1508685322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONISHA CORTESE HALE

Provider Business Mailing Address
First Line	:	404 N HOLLY AVE
Second Line	:
City	:	COMPTON
State	:	CA
Zip	:	90221-2316
Country	:	US
Telephone Number	:	323-996-8614
Fax Number	:

Provider Business Practice Location Address
First Line	:	4083 ABOURNE RD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-3221
Country	:	US
Telephone Number	:	323-996-8614
Fax Number	:

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

Provider Enumeration Date	:	10/08/2024
Last Update Date	:	10/08/2024

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Directions to “ DONISHA CORTESE HALE ” Practice Location

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