Individual
TAMARA MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S. OCCUPATIONAL TH
Contact information
Practice address
1663 NOYES AVE, IRVINE, CA 92606
(949) 252-9946
Mailing address
7 VILLORIA, IRVINE, CA 92602-0938
(714) 544-9309
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
3995
CA
Other
Enumeration date
12/24/2007
Last updated
12/24/2007
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