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NPI Code Detail

MEDICARE: LV SPEECH THERAPY GROUP, INC.

MEDICARE: LV SPEECH THERAPY GROUP, INC.
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
1235Z00000XSpeech-Language Pathologist18817CA

General Provider Information

NPI Number : 1801241583
Entity Type Code : Organization
Provider Name (Legal Business Name) : LV SPEECH THERAPY GROUP, INC.
Provider Business Mailing Address
First Line : 3620 LONG BEACH BLVD STE A1
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-6014
Country : US
Telephone Number : 310-930-7491
Fax Number :
Provider Business Practice Location Address
First Line : 3620 LONG BEACH BLVD STE A1
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-6014
Country : US
Telephone Number : 310-930-7491
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DAMON PAPPO
Credential :
Telephone Number : 562-595-0912
Provider Enumeration Date : 04/29/2016
Last Update Date : 04/29/2016

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Directions to “LV SPEECH THERAPY GROUP, INC. ” Practice Location

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