Provider Demographics
NPI:1467604694
Name:SOUTH COAST THERAPY, INC.
Entity Type:Organization
Organization Name:SOUTH COAST THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-893-7399
Mailing Address - Street 1:11205 KNOTT AVE STE E
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5489
Mailing Address - Country:US
Mailing Address - Phone:714-893-7399
Mailing Address - Fax:714-893-7389
Practice Address - Street 1:11205 KNOTT AVE STE E
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5489
Practice Address - Country:US
Practice Address - Phone:714-893-7399
Practice Address - Fax:714-893-7389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT117592251P0200X
CAAT 8808225200000X
CAOT 3708225XF0002X
CAOT6847225XP0200X
CASP 16790235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & SwallowingGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty