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General NPI Number Information
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NPI Number | 1699967885
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Entity Type | Organization
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Legal Business Name | COACHELLA VALLEY REHABILITATION
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 08/13/2007
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Provider Practice Location Address
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Address Line | 1586 6TH STREET
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City | COACHELLA
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State | CA
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Zip | 92236
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Country | US
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Telephone | 760-398-3844
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Fax | 760-398-5033
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Provider Business Mailing Address
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Address Line | PO BOX 2110
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City | PALM SPRINGS
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State | CA
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Zip | 92263-2110
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Country | US
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Telephone | 760-778-1662
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Fax | 760-778-1662
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Authorized Official
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Title or Position | OWNER
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Name | PAULA EVANS
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Credential |
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Telephone | 760-778-1660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC11257
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License Number State | CA
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