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Organization subpart
No

Provider details

NPI number
Authorized official
SYDEL KHOE OTR/L (PROVIDER)
(626) 339-0268
Entity
Organization

Contact information

Practice address
339 E ROWLAND ST, COVINA, CA 91723-3153
(626) 339-0268
(626) 371-0423
Mailing address
339 E ROWLAND ST, COVINA, CA 91723-3153
(626) 339-0268
(626) 371-0423

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 5376
CA

Other

Enumeration date
11/09/2009
Last updated
06/05/2013
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