MEDICARE: MS. SHU YI CHEN OTRIL

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	225X00000X	Occupational Therapist	3860	CA

General Provider Information

NPI Number	:	1619031929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHU YI CHEN OTRIL

Provider Business Mailing Address
First Line	:	3942 MAXSON RD
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	97132
Country	:	US
Telephone Number	:	626-374-2233
Fax Number	:

Provider Business Practice Location Address
First Line	:	3942 MAXSON RD
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	97132
Country	:	US
Telephone Number	:	626-374-2233
Fax Number	:

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	07/08/2007

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