MEDICARE: AURA BETETA

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1750543500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AURA BETETA

Provider Business Mailing Address
First Line	:	5415 PERCY ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-3305
Country	:	US
Telephone Number	:	323-888-0445
Fax Number	:

Provider Business Practice Location Address
First Line	:	6055 E WASHINGTON BLVD
Second Line	:
City	:	COMMERCE
State	:	CA
Zip	:	90040-2449
Country	:	US
Telephone Number	:	323-346-0960
Fax Number	:	323-346-0966

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

Provider Enumeration Date	:	07/01/2008
Last Update Date	:	07/01/2008

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Directions to “ AURA BETETA ” Practice Location

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