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NPI Code Detail

MEDICARE: ANAIS ISABEL OCON

MEDICARE:   ANAIS ISABEL OCON
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
12255A2300XAthletic TrainerCA

General Provider Information

NPI Number : 1790513935
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANAIS ISABEL OCON
Provider Business Mailing Address
First Line : 1231 GLENWOOD RD
Second Line :
City : GLENDALE
State : CA
Zip : 91202-2049
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1231 GLENWOOD RD
Second Line :
City : GLENDALE
State : CA
Zip : 91202-2049
Country : US
Telephone Number : 626-328-0135
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2024
Last Update Date : 07/22/2024

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Directions to “ ANAIS ISABEL OCON ” Practice Location

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