1992879639 NPI number — ATG REHAB SPECIALISTS INC

Table of content: (NPI 1992879639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992879639 NPI number — ATG REHAB SPECIALISTS INC

Organization/Personal Information

Employer Identification Number (EIN):
N/A
Provider Organization Name:
ATG REHAB SPECIALISTS INC
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:
NUMOTION
Provider Other Organization Name Type Code:
3
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:
1992879639
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1650 TRIBUTE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95815-4400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-489-3651
Provider Business Mailing Address Fax Number:
916-489-1455

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3500 THOMAS RD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA CLARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-522-1200
Provider Business Practice Location Address Fax Number:
408-736-0203
Provider Enumeration Date:
11/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FEITEL
Authorized Official First Name:
TAMAS
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
860-257-3443

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BC3200X , with the licence number: 100863 , 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)

  • Identifier: 297326885 . This is a "STANFORD PRE PAID HEALTH" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 217216 . This is a "HIGHMARK BLUE SHIELDS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 77-0121738 . This is a "METRA-HEALTH" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "PRIVATE INSURANCE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 132576600 . This is a "US DPT OF LABOR" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: DME 00819G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: DME 02896F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6639600 . This is a "HEALTH CARE ADMIN." identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".