Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | ||
N | 225X00000X | Occupational Therapist | OT4713 | CA |
N | 2251E1200X | Ergonomics | ||
N | 225XE1200X | Ergonomics | ||
Y | 225XH1200X | Occupational Therapist - Hand | ||
N | 225XN1300X | Occupational Therapist - Neurorehabilitation |
NPI | 1639269277 |
---|---|
Provider Name | Paul S Gerstenfeld |
First Address | Santa Monica, CA 90403-1752 |
Second Address | Santa Monica, CA 90405-1076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 07/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1059271 | NBCOT (01) | CA |
OT4713 | CBOT (01) | CA |