1821304866 NPI number — SOUTHERN CALIFORNIA REHABILITATION SERVICES, 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 1821304866 NPI number — SOUTHERN CALIFORNIA REHABILITATION SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHERN CALIFORNIA REHABILITATION SERVICES, 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:
1821304866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 SOUTH FREMONT AVE
Provider Second Line Business Mailing Address:
BLDG B1, SUITE B10100, BOX #99
Provider Business Mailing Address City Name:
ALHAMBRA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-587-5010
Provider Business Mailing Address Fax Number:
626-382-2501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7830 QUILL DR
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90242-3440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-862-6531
Provider Business Practice Location Address Fax Number:
562-923-5274
Provider Enumeration Date:
08/27/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CONTRERAS
Authorized Official First Name:
RUDY
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
626-587-5010

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  444863 , 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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