MEDICARE: DR. PATRICIA ISABELLA COMMER DPT

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	32271	CA

General Provider Information

NPI Number	:	1578176780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA ISABELLA COMMER DPT

Provider Business Mailing Address
First Line	:	1777 BOTELHO DR STE 115
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94596-5086
Country	:	US
Telephone Number	:	925-210-0321
Fax Number	:

Provider Business Practice Location Address
First Line	:	4146 RANDOLPH AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94602-1314
Country	:	US
Telephone Number	:	510-932-9569
Fax Number	:

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

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	08/26/2020

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