Tori Takata, | |
5539 E Stearns St, Long Beach, CA 90815-3125 | |
(562) 855-1129 | |
Not Available |
Full Name | Tori Takata |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 5539 E Stearns St, Long Beach, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245958578 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 302671 (California) | Primary |
Provider Name | California Rehabilitation & Sports Therapy A California Physical Ther |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1386696409 PECOS PAC ID: 6709788896 Enrollment ID: O20040120001115 |
Mailing Address | Practice Location Address |
---|---|
Tori Takata, 2603 Bayport Dr, Torrance, CA 90503-8923 Ph: (310) 625-8344 | Tori Takata, 5539 E Stearns St, Long Beach, CA 90815-3125 Ph: (562) 855-1129 |
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