Healthcare Provider Details

I. General information

NPI: 1316878127
Provider Name (Legal Business Name): OSWALDO COTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 E PALMDALE BLVD STE C
PALMDALE CA
93550-4914
US

IV. Provider business mailing address

1703 WOODBRIDGE AVE
PALMDALE CA
93550-6921
US

V. Phone/Fax

Practice location:
  • Phone: 666-947-9554
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: