Provider Demographics
NPI:1326804543
Name:DANIEL PADILLA VEGA OT APC
Entity Type:Organization
Organization Name:DANIEL PADILLA VEGA OT APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ALEJANDRO
Authorized Official - Last Name:PADILLA VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:818-571-1817
Mailing Address - Street 1:15855 SATICOY ST APT 6
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3163
Mailing Address - Country:US
Mailing Address - Phone:818-571-1817
Mailing Address - Fax:
Practice Address - Street 1:15855 SATICOY ST APT 6
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3163
Practice Address - Country:US
Practice Address - Phone:818-571-1817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty