MEDICARE: LAURETTE PEPIN PT

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	225100000X	Physical Therapist	PT29940	CA

General Provider Information

NPI Number	:	1750430641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURETTE PEPIN PT

Provider Business Mailing Address
First Line	:	730 EMPEY WAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-4705
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	730 EMPEY WAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-4705
Country	:	US
Telephone Number	:	408-275-1500
Fax Number	:

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	12/18/2024

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Directions to “ LAURETTE PEPIN PT” Practice Location

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