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NPI Code Detail

MEDICARE: MARY JOY CODILLA

MEDICARE: MARY JOY CODILLA
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
1225200000XPhysical Therapy AssistantAT8112CA

General Provider Information

NPI Number : 1801284922
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY JOY CODILLA
Provider Business Mailing Address
First Line : 260 E MARKET ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90805-5910
Country : US
Telephone Number : 562-428-4681
Fax Number :
Provider Business Practice Location Address
First Line : 260 E MARKET ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90805-5910
Country : US
Telephone Number : 562-428-4681
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2014
Last Update Date : 06/17/2016

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Directions to “ MARY JOY CODILLA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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