Provider Demographics
NPI:1689738627
Name:NORTH COAST PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:NORTH COAST PHYSICAL THERAPY INC
Other - Org Name:NORTH COAST PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:760-729-7298
Mailing Address - Street 1:3633 VISTA WAY
Mailing Address - Street 2:101
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4568
Mailing Address - Country:US
Mailing Address - Phone:760-729-7298
Mailing Address - Fax:760-729-7206
Practice Address - Street 1:3633 VISTA WAY
Practice Address - Street 2:101
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4568
Practice Address - Country:US
Practice Address - Phone:760-729-7298
Practice Address - Fax:760-729-7206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18003OtherMEDICARE LEGACY # W18003