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NPI Code Detail

MEDICARE: VIBRANTCARE OUTPATIENT REHABILITATION OF CALIFORNIA INC

MEDICARE: VIBRANTCARE OUTPATIENT REHABILITATION OF CALIFORNIA INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1235133711
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIBRANTCARE OUTPATIENT REHABILITATION OF CALIFORNIA INC
Provider Business Mailing Address
First Line : PO BOX 840343
Second Line :
City : LOS ANGELES
State : CA
Zip : 90084-0343
Country : US
Telephone Number : 916-789-8115
Fax Number : 916-773-1481
Provider Business Practice Location Address
First Line : 2160 APPIAN WAY
Second Line : STE 101
City : PINOLE
State : CA
Zip : 94564-2524
Country : US
Telephone Number : 510-724-1248
Fax Number : 510-724-5720
Authorized Official
Title or Position : CEO
Name : MR. DAVID SMITH
Credential :
Telephone Number : 916-782-1212
Provider Enumeration Date : 06/13/2005
Last Update Date : 11/22/2023

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Directions to “VIBRANTCARE OUTPATIENT REHABILITATION OF CALIFORNIA INC ” Practice Location

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