Healthcare Provider Details

I. General information

NPI: 1710401302
Provider Name (Legal Business Name): CA POST ACUTE SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2017
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HARTNELL AVE
REDDING CA
96002-1843
US

IV. Provider business mailing address

119 S WESTERN AVE UNIT 1
CHICAGO IL
60612-4644
US

V. Phone/Fax

Practice location:
  • Phone: 800-411-6768
  • Fax:
Mailing address:
  • Phone: 800-411-6768
  • Fax: 855-751-8051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LAUREL DOTAS
Title or Position: CHIEF OPERATING OFFICE
Credential:
Phone: 352-215-1603