Basic Information
| Provider Information | |||||||||
| NPI: | 1295076891 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAURIA | ||||||||
| FirstName: | JULIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2641 | ||||||||
| Address2: | |||||||||
| City: | CHINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917082641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5623967459 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11317 RMAONA BLVD. | ||||||||
| Address2: | STE.C | ||||||||
| City: | IRWINDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6269604020 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2013 | ||||||||
| LastUpdateDate: | 03/06/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225400000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |
No ID Information.