1386696409 NPI number — CALIFORNIA REHABILITATION & SPORTS THERAPY A CALIFORNIA PHYSICAL THER

Table of content: DR. MARIA CLARISSA ONG TIO M.D. (NPI 1508253188)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386696409 NPI number — CALIFORNIA REHABILITATION & SPORTS THERAPY A CALIFORNIA PHYSICAL THER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CALIFORNIA REHABILITATION & SPORTS THERAPY A CALIFORNIA PHYSICAL THER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386696409
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2600 DALLAS PKWY STE 290
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034-7493
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
945-050-0010
Provider Business Mailing Address Fax Number:
949-644-0316

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26302 LA PAZ RD
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
MISSION VIEJO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92691-5313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-206-1700
Provider Business Practice Location Address Fax Number:
949-206-1800
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PACE
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
213-804-1712

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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