MEDICARE: MR. SCOTT TAKESHI NAKAMOTO PT

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	2251X0800X	Orthopedic Physical Therapist	PT13288	CA

General Provider Information

NPI Number	:	1538111562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT TAKESHI NAKAMOTO PT

Provider Business Mailing Address
First Line	:	25231 WESTON RD
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90505-6931
Country	:	US
Telephone Number	:	310-486-3520
Fax Number	:

Provider Business Practice Location Address
First Line	:	15898 GALE AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-1601
Country	:	US
Telephone Number	:	626-369-9020
Fax Number	:

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	06/18/2008

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