Healthcare Provider Details

I. General information

NPI: 1396383402
Provider Name (Legal Business Name): AZ REHAB CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2019
Last Update Date: 09/04/2026
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6049 S COBBLESTONE ST
GILBERT AZ
85298
US

IV. Provider business mailing address

3317 S HIGLEY RD STE 114
GILBERT AZ
85297-5437
US

V. Phone/Fax

Practice location:
  • Phone: 805-300-1464
  • Fax:
Mailing address:
  • Phone: 805-300-1464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH WONG
Title or Position: OWNER
Credential:
Phone: 216-390-1402