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NPI Code Detail

MEDICARE: LISA LE OTD, OTR/L

MEDICARE: LISA LE OTD, 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 Therapist20764CA

General Provider Information

NPI Number : 1619482122
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA LE OTD, OTR/L
Provider Business Mailing Address
First Line : 823 S ALMANSOR ST
Second Line :
City : ALHAMBRA
State : CA
Zip : 91801-4510
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 242 E 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90014-2117
Country : US
Telephone Number : --
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2017
Last Update Date : 10/17/2023

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Directions to “ LISA LE OTD, OTR/L” Practice Location

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