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NPI Code Detail

MEDICARE: MS. NANCY ANN BANDY MOT, OTR/L

MEDICARE: MS. NANCY ANN BANDY MOT, 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 Therapist2036CA

General Provider Information

NPI Number : 1558303180
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NANCY ANN BANDY MOT, OTR/L
Provider Business Mailing Address
First Line : 4768 POCAHONTAS AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92117-2648
Country : US
Telephone Number : 858-270-0880
Fax Number :
Provider Business Practice Location Address
First Line : 3350 LA JOLLA VILLAGE DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92161-0002
Country : US
Telephone Number : 858-552-8585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2006
Last Update Date : 07/08/2007

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