Provider Demographics
NPI:1295203065
Name:LOUFF, BRYAN (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:LOUFF
Suffix:
Gender:M
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3617 W 181ST ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-3918
Mailing Address - Country:US
Mailing Address - Phone:310-779-4387
Mailing Address - Fax:
Practice Address - Street 1:3617 W 181ST ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-3918
Practice Address - Country:US
Practice Address - Phone:310-779-4387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT-18411225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist