Individual
ANECITO TEDOCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
6041 CADILLAC AVE, LOS ANGELES, CA 90034-1702
(323) 857-2000
(626) 405-6768
Mailing address
393 E WALNUT ST, 3RD FLOOR - PHR SYSTEMS, PASADENA, CA 91188-0001
(626) 405-7914
(626) 405-6768
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
00000774
CA
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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