Provider Demographics
NPI:1194863456
Name:UNGAR, MARGIE (OTR)
Entity Type:Individual
Prefix:
First Name:MARGIE
Middle Name:
Last Name:UNGAR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 EDGEHILL DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3616
Mailing Address - Country:US
Mailing Address - Phone:650-344-5979
Mailing Address - Fax:650-579-6014
Practice Address - Street 1:1200 EDGEHILL DR
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3616
Practice Address - Country:US
Practice Address - Phone:650-344-5979
Practice Address - Fax:650-579-6014
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 7959225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACT2187430Medicaid