Organization
COASTSIDE PHYSICAL THERAPY
Active
Other names
Coastside Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE LASSON (VICE PRESIDENT)
(408) 570-0510
Entity
Organization
Contact information
Practice address
52 AURA VISTA DR, PACIFICA, CA 94044-1848
(650) 355-4558
(650) 355-4645
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
12/01/2005
Last updated
12/05/2007
Update your record
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