Healthcare Provider Details
I. General information
NPI: 1851445266
Provider Name (Legal Business Name): DESIGNER HEALTH & REHAB MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17777 MAIN ST SUITE D BUILDING 60
IRVINE CA
92614-4795
US
IV. Provider business mailing address
17777 MAIN ST SUITE D BUILDING 60
IRVINE CA
92614-4795
US
V. Phone/Fax
- Phone: 949-433-5000
- Fax: 949-660-1512
- Phone: 949-433-5000
- Fax: 949-660-1512
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CAROL
RAE
SOLOWAY
Title or Position: PARTNER
Credential: DC
Phone: 949-433-5000