Healthcare Provider Details

I. General information

NPI: 1639269277
Provider Name (Legal Business Name): PAUL S GERSTENFELD MS, OTR/L, CHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 BAY ST UNIT 21
SANTA MONICA CA
90405-1076
US

IV. Provider business mailing address

858 14TH ST APT 3
SANTA MONICA CA
90403-1752
US

V. Phone/Fax

Practice location:
  • Phone: 310-396-8565
  • Fax: 310-396-0052
Mailing address:
  • Phone: 619-417-2187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT4713
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: