Provider Demographics
NPI:1811192818
Name:PAGEL, PAMELA ANNE (OT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANNE
Last Name:PAGEL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27525 ENTERPRISE CIR W
Mailing Address - Street 2:101 C
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4864
Mailing Address - Country:US
Mailing Address - Phone:951-676-7693
Mailing Address - Fax:951-676-7830
Practice Address - Street 1:27525 ENTERPRISE CIR W
Practice Address - Street 2:101 C
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4864
Practice Address - Country:US
Practice Address - Phone:951-676-7693
Practice Address - Fax:951-676-7830
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT1431174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOT1431OtherSTATE LICENSE