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General NPI Number Information
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NPI Number | 1194422766
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Entity Type | Individual
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Provider Name | KEVIN PAUL COTA/L
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Gender | Male
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Dates
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Enumeration Date | 02/14/2023
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 39950 VISTA DEL SOL
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-3206
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Country | US
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Telephone | 760-340-0053
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Fax |
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Provider Business Mailing Address
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Address Line | 480 BRADSHAW LN # 6
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City | PALM SPRINGS
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State | CA
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Zip | 92262-7950
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Country | US
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Telephone | 909-528-6760
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 358503
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License Number State | CA
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