MEDICARE: ALEXANDER TOUSSAINT COTA/L

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	224Z00000X	Occupational Therapy Assistant	4275	CA

General Provider Information

NPI Number	:	1790399913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER TOUSSAINT COTA/L

Provider Business Mailing Address
First Line	:	3731 E HARDING ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-3934
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3731 E HARDING ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-3934
Country	:	US
Telephone Number	:	310-982-5624
Fax Number	:

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

Provider Enumeration Date	:	09/04/2020
Last Update Date	:	09/04/2020

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