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General NPI Number Information
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NPI Number | 1013343516
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Entity Type | Organization
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Legal Business Name | COALINGA STATE HOSPITAL
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 8242 SUNNYSEA DR
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City | PLAYA DEL REY
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State | CA
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Zip | 90293-7941
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Country | US
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Telephone | 310-874-0658
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Fax |
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Provider Business Mailing Address
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Address Line | 8242 SUNNYSEA DR
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City | PLAYA DEL REY
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State | CA
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Zip | 90293-7941
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Country | US
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Telephone | 310-874-0658
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. DONALD GENE RUBISH
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Credential | STATE HEALTH CARE
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Telephone | 559-934-8552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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