Provider Demographics
NPI:1316305030
Name:COASTAL HAND & OCCUPATIONAL THERAPY
Entity type:Organization
Organization Name:COASTAL HAND & OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:T
Authorized Official - Last Name:CALE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:805-922-1724
Mailing Address - Street 1:201 N COLLEGE DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4614
Mailing Address - Country:US
Mailing Address - Phone:805-922-1724
Mailing Address - Fax:805-922-2765
Practice Address - Street 1:150 MARY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:NIPOMO
Practice Address - State:CA
Practice Address - Zip Code:93444-7820
Practice Address - Country:US
Practice Address - Phone:805-929-3230
Practice Address - Fax:805-929-3232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COASTAL HAND & OCCUPATIONAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty