MEDICARE: MS. MICHELLE ANN WEINANDY M.P.T.

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	PT19704	CA

General Provider Information

NPI Number	:	1801848510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE ANN WEINANDY M.P.T.

Provider Business Mailing Address
First Line	:	27432 ALISO CREEK RD
Second Line	:	SUITE 100
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-5337
Country	:	US
Telephone Number	:	949-448-0872
Fax Number	:	949-448-0984

Provider Business Practice Location Address
First Line	:	27432 ALISO CREEK RD
Second Line	:	SUITE 100
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-5337
Country	:	US
Telephone Number	:	949-448-0872
Fax Number	:	949-448-0984

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	05/19/2011

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