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General NPI Number Information
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NPI Number | 1316926462
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Entity Type | Individual
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Provider Name | GEORGE SIEGEL M.A.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2006
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Last Update Date | 08/18/2024
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Provider Practice Location Address
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Address Line | 1600 W COAST HWY STE G
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-5000
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Country | US
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Telephone | 949-650-0456
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Fax | 949-650-0921
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Provider Business Mailing Address
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Address Line | 481 E 19TH ST
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City | COSTA MESA
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State | CA
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Zip | 92627-2313
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Country | US
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Telephone | 949-650-0456
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Fax | 949-650-0921
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6791
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License Number State | CA
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