Provider Demographics
NPI:1508088436
Name:HOESLY, CAROL REMZ (PT)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:REMZ
Last Name:HOESLY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:CAROL
Other - Middle Name:J
Other - Last Name:REMZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:812 HARKNESS ST.
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6330
Mailing Address - Country:US
Mailing Address - Phone:310-374-2324
Mailing Address - Fax:310-374-5035
Practice Address - Street 1:812 HARKNESS ST.
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6330
Practice Address - Country:US
Practice Address - Phone:310-374-2324
Practice Address - Fax:310-374-5035
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT86352251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACMS037225OtherMEDI-CAL PROVIDER NUMBER