MEDICARE: JULIA SONG 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	3204	CA

General Provider Information

NPI Number	:	1821537796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA SONG COTA/L

Provider Business Mailing Address
First Line	:	21817 FIGUEROA ST UNIT 2
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90745-1936
Country	:	US
Telephone Number	:	818-913-5696
Fax Number	:

Provider Business Practice Location Address
First Line	:	21817 FIGUEROA ST UNIT 2
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90745-1936
Country	:	US
Telephone Number	:	818-913-5696
Fax Number	:

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

Provider Enumeration Date	:	02/13/2017
Last Update Date	:	02/13/2017

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Directions to “ JULIA SONG COTA/L” Practice Location

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