MEDICARE: CECILIA R MUMAR

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	374U00000X	Home Health Aide		CA

General Provider Information

NPI Number	:	1710637095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILIA R MUMAR

Provider Business Mailing Address
First Line	:	1023 N HOLLYWOOD WAY STE 207
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2543
Country	:	US
Telephone Number	:	818-588-3102
Fax Number	:	818-337-2920

Provider Business Practice Location Address
First Line	:	1023 N HOLLYWOOD WAY STE 207
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2543
Country	:	US
Telephone Number	:	818-588-3102
Fax Number	:	818-337-2920

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

Provider Enumeration Date	:	03/28/2022
Last Update Date	:	03/28/2022

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Directions to “ CECILIA R MUMAR ” Practice Location

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