Provider Demographics
NPI:1043498082
Name:PALOS VERDES HAND THERAPY
Entity Type:Organization
Organization Name:PALOS VERDES HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:HOCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL HTC
Authorized Official - Phone:310-539-4494
Mailing Address - Street 1:3400 LOMITA BLVD
Mailing Address - Street 2:SUITE 401A
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4929
Mailing Address - Country:US
Mailing Address - Phone:310-539-4494
Mailing Address - Fax:310-539-5546
Practice Address - Street 1:3400 LOMITA BLVD
Practice Address - Street 2:SUITE 401A
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4929
Practice Address - Country:US
Practice Address - Phone:310-539-4494
Practice Address - Fax:310-539-5546
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALOS VERDES HAND THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT5588225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4744930001Medicare NSC