MEDICARE: BRIAN V TOPACIO

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	225200000X	Physical Therapy Assistant	PTA8910	CA

General Provider Information

NPI Number	:	1942798269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN V TOPACIO

Provider Business Mailing Address
First Line	:	6123 IBBETSON AVE
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90713-1043
Country	:	US
Telephone Number	:	562-810-1915
Fax Number	:

Provider Business Practice Location Address
First Line	:	3111 SANTA ANITA AVE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91733-1357
Country	:	US
Telephone Number	:	626-443-0218
Fax Number	:

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

Provider Enumeration Date	:	04/23/2018
Last Update Date	:	04/23/2018

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Directions to “ BRIAN V TOPACIO ” Practice Location

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