Provider Information
Last Updated: Nov 24 2025 4:22 PM
Ed A Detels
City La Mesa |
Group Premier Patient Care IPA |
Specialty Occupational Therapist |
Last Name Detels |
First Name Ed |
Middle Name A |
Address 5905 Severin Dr |
State CA |
Zip Code 91942-3806 |
Phone (619) 589-2606 |
Hours M-F 7AM-6PM |
Gender M |
Title OT |
Section Number 4 |
County San Diego |
Accepting New Patient Yes |
NPI Number 1427033604 |
PARKING_IND P |
EXT_BUILD_IND EB |
INT_BUILD_IND IB |
RESTROOM_IND R |
License ID 1096 |
Email credentialing@prnpt.com |
Office Language Spanish |
Panel Status E |