MEDICARE: MS. MARIDALE R ORPILLA OTR

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	8660	CA

General Provider Information

NPI Number	:	1679500631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIDALE R ORPILLA OTR

Provider Business Mailing Address
First Line	:	11732 214TH ST
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90715-2102
Country	:	US
Telephone Number	:	562-924-1449
Fax Number	:

Provider Business Practice Location Address
First Line	:	11732 214TH ST
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90715-2102
Country	:	US
Telephone Number	:	562-924-1449
Fax Number	:

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

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	07/08/2007

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