Healthcare Provider Details

I. General information

NPI: 1063276343
Provider Name (Legal Business Name): LINDSAY GELLA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY FORD OTR/L

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 02/07/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6264 FERRIS SQ
SAN DIEGO CA
92121-3204
US

IV. Provider business mailing address

125 ARBOR DR APT 1
SAN DIEGO CA
92103-2058
US

V. Phone/Fax

Practice location:
  • Phone: 619-940-4128
  • Fax:
Mailing address:
  • Phone: 763-234-7688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number17899
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: