Individual
MRS. SIMA A KOTHARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3415 W BALL RD, ANAHEIM, CA 92804-3708
(714) 826-8950
Mailing address
3415 W BALL RD, ANAHEIM, CA 92804-3708
(714) 826-8950
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
OTA2189
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
284122
NBCOT
CA
Enumeration date
08/25/2015
Last updated
08/25/2015
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