MEDICARE: GEORGETTE CORPIN

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	34633	CA

General Provider Information

NPI Number	:	1760914998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGETTE CORPIN

Provider Business Mailing Address
First Line	:	3138 BOULDERS CT
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94806-5734
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3138 BOULDERS CT
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94806-5734
Country	:	US
Telephone Number	:	415-279-8982
Fax Number	:

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

Provider Enumeration Date	:	03/28/2017
Last Update Date	:	03/28/2017

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Directions to “ GEORGETTE CORPIN ” Practice Location

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