Provider Demographics
NPI:1063521987
Name:TECH COAST REHAB INC
Entity type:Organization
Organization Name:TECH COAST REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:CECILE
Authorized Official - Last Name:GAITA
Authorized Official - Suffix:
Authorized Official - Credentials:MOT, OTR/L
Authorized Official - Phone:949-654-1369
Mailing Address - Street 1:4200 TRABUCO RD
Mailing Address - Street 2:SUITE 165
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3600
Mailing Address - Country:US
Mailing Address - Phone:949-654-1369
Mailing Address - Fax:949-654-1383
Practice Address - Street 1:4200 TRABUCO RD
Practice Address - Street 2:SUITE 165
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3600
Practice Address - Country:US
Practice Address - Phone:949-654-1369
Practice Address - Fax:949-654-1383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2033225000000X, 225XE1200X, 225XH1200X, 225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Single Specialty
Not Answered225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomicsGroup - Single Specialty
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Not Answered225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5797733OtherAETNA PIN
CAOT0020330OtherBLUE SHIELD PIN
CAZZZ05623ZOtherBLUE SHIELD GROUP
CAWN522748AMedicare ID - Type UnspecifiedMEDICARE PPIN
CA4571110001Medicare NSC
CA5797733OtherAETNA PIN