1457333908 NPI number — BURGER PHYSICAL THERAPY AND REHABILITATION AGENCY INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457333908 NPI number — BURGER PHYSICAL THERAPY AND REHABILITATION AGENCY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BURGER PHYSICAL THERAPY AND REHABILITATION AGENCY 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:
Provider Other Organization Name Type Code:
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:
1457333908
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 E BIDWELL ST
Provider Second Line Business Mailing Address:
#201
Provider Business Mailing Address City Name:
FOLSOM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95630-3452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-983-5915
Provider Business Mailing Address Fax Number:
916-983-5925

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 E BIDWELL ST
Provider Second Line Business Practice Location Address:
#101
Provider Business Practice Location Address City Name:
FOLSOM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95630-3452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-983-5915
Provider Business Practice Location Address Fax Number:
916-983-5925
Provider Enumeration Date:
11/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BURGER
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
916-983-5915

Provider Taxonomy Codes

  • Taxonomy code: 261QR0401X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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