MEDICARE: ETHEL LILIBETH PIO

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	374J00000X	Doula		CA

General Provider Information

NPI Number	:	1902651409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ETHEL LILIBETH PIO

Provider Business Mailing Address
First Line	:	7133 MARINA PACIFICA DR S
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-3818
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7133 MARINA PACIFICA DR S KEY 8
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-3818
Country	:	US
Telephone Number	:	818-497-7710
Fax Number	:

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

Provider Enumeration Date	:	04/19/2024
Last Update Date	:	04/19/2024

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Directions to “ ETHEL LILIBETH PIO ” Practice Location

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