Provider Demographics
NPI:1013054584
Name:DIMEGLIO, PAUL JAMES (OTR/L, HTC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:JAMES
Last Name:DIMEGLIO
Suffix:
Gender:M
Credentials:OTR/L, HTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24630 WASHINGTON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6177
Mailing Address - Country:US
Mailing Address - Phone:951-200-3620
Mailing Address - Fax:951-200-5811
Practice Address - Street 1:29645 RANCHO CALIFORNIA RD
Practice Address - Street 2:STE. 234
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-6200
Practice Address - Country:US
Practice Address - Phone:951-506-3001
Practice Address - Fax:951-506-3002
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 6025225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP369ZMedicare PIN
CACP369YMedicare PIN