Angela K Prescott is a Sports in La Quinta, California. Angela K Prescott practices all healthcare services and medical treatments related to Sports. The NPI Number for Angela K Prescott is 1689884991. The last update date is 2014-05-27.
Angela K Prescott's current location address is 78365 Highway 111, La Quinta, California. You can contact this provider via phone number 7603246400 and fax number 7603288216. The mailing address for Angela K Prescott is 78365 Highway 111, La Quinta, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Angela K Prescott |
|---|---|
| Address | 78365 Highway 111, La Quinta, California |
| Phone Number | 7603246400 |
| Fax Number | 7603288216 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER LI |
|---|---|
| Authorized Official Name | Prescott Kaylene Angela |
| Credentials | PT |
| Telephone Number | 7603246400 |
NPI Number Detail
| NPI Number | 1689884991 |
|---|---|
| Provider Enumeration Date | 2007-05-23 |
| Last Updated Date | 2014-05-27 |
Provider Mailing Address Detail
| Address | 78365 Highway 111 |
|---|---|
| City | La Quinta |
| State | California (CA) |
| Post Code | 922532071 |
| Phone Number | 7603246400 |
| Fax Number | 7603288216 |
Provider's Primary Taxonomy Detail
| Speciality | Sports |
|---|---|
| Taxonomy | 2251S0007X |
| Licence No | 2251S0007X |
|
Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, patholog |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0PT193551 | CA | MEDICARE PTAN INDIVIDUAL | |
| ZZZ29525Z | CA | MEDICARE PTAN GROUP |
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What is the unique 10-digit identification code assigned to Angela K Prescott by the Centers for Medicare & Medicaid Services?
The Angela K Prescott has been issued the NPI (National Provider Identifier) 1689884991, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Angela K Prescott located?
The Angela K Prescott is located at 78365 Highway 111, La Quinta, CA 922532071.
What is the Angela K Prescott's specialty and taxonomy code?
The Angela K Prescott's specialty is Sports, and the corresponding taxonomy code is 2251S0007X.
On what date did the Angela K Prescott receive the assignment of its 1689884991 from the Centers for Medicare & Medicaid Services?
The Angela K Prescott was issued its 1689884991 by the Centers for Medicare & Medicaid Services on 2007-05-23.
As of what date were the Angela K Prescott's details last updated?
The information pertaining to the Angela K Prescott, including its address, specialty, and other details, was most recently updated on 2014-05-27.
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