Provider Demographics
NPI:1144384181
Name:BOLLIER, MARIA LUISA (PT DPT CHT)
Entity Type:Individual
Prefix:
First Name:MARIA LUISA
Middle Name:
Last Name:BOLLIER
Suffix:
Gender:F
Credentials:PT DPT CHT
Other - Prefix:
Other - First Name:MARIA LUISA
Other - Middle Name:BAUTISTA
Other - Last Name:BOLLIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPT
Mailing Address - Street 1:6850 LINCOLN AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-4180
Mailing Address - Country:US
Mailing Address - Phone:714-527-9240
Mailing Address - Fax:714-527-9230
Practice Address - Street 1:6850 LINCOLN AVE STE 205
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-4180
Practice Address - Country:US
Practice Address - Phone:714-527-9240
Practice Address - Fax:714-527-9230
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT17870225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT17870BMedicare ID - Type UnspecifiedORANGE COUNTY PPIN
CAWPT17870AMedicare ID - Type UnspecifiedLA COUNTY PPIN