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NPI Code Detail

MEDICARE: PEECHIT BUTRANON RPT, RN

MEDICARE:   PEECHIT  BUTRANON  RPT, RN
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1932710654
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEECHIT BUTRANON RPT, RN
Provider Business Mailing Address
First Line : 6173 LA COSTA
Second Line :
City : FONTANA
State : CA
Zip : 92336-5684
Country : US
Telephone Number : 323-420-8233
Fax Number :
Provider Business Practice Location Address
First Line : 6173 LA COSTA
Second Line :
City : FONTANA
State : CA
Zip : 92336-5684
Country : US
Telephone Number : 323-420-8233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2020
Last Update Date : 08/14/2020

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Directions to “ PEECHIT BUTRANON RPT, RN” Practice Location

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