Organization
COASTSIDE PHYSICAL THERAPY
Active
Other names
Coastside Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE LASSON (VICE PRESDENT)
(408) 570-0510
Entity
Organization
Contact information
Practice address
799 MAIN ST, SUITE D, HALF MOON BAY, CA 94019-1996
(650) 726-6378
(650) 726-6389
Mailing address
PO BOX 612260, SAN JOSE, CA 95161-2260
(877) 325-2776
(408) 945-4011
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1321715
CIGNA
CA
01
—
8156597
AETNA
CA
01
—
ZZZ20234Z
BLUESHIELD
CA
Enumeration date
12/05/2005
Last updated
10/08/2007
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