Healthcare Provider Details

I. General information

NPI: 1316537947
Provider Name (Legal Business Name): MURDOCK REHAB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2021
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2163 SHIRE DR
EL CAJON CA
92019-2657
US

IV. Provider business mailing address

PO BOX 21773
EL CAJON CA
92021-0966
US

V. Phone/Fax

Practice location:
  • Phone: 619-715-5811
  • Fax: 619-334-7338
Mailing address:
  • Phone: 619-715-5811
  • Fax: 619-334-7338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DARYL MURDOCK
Title or Position: PRESIDENT
Credential: PT
Phone: 619-715-5811