Healthcare Provider Details

I. General information

NPI: 1659756450
Provider Name (Legal Business Name): REHAB ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 07/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 MT VIEW AVE
LOMA LINDA CA
92354-1727
US

IV. Provider business mailing address

22995 MILL CREEK DR
LAGUNA HILLS CA
92653-1215
US

V. Phone/Fax

Practice location:
  • Phone: 909-796-6915
  • Fax: 909-799-6205
Mailing address:
  • Phone: 949-707-5555
  • Fax: 949-707-5706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License NumberPT5709
License Number StateCA

VIII. Authorized Official

Name: MR. DAVID HAYES
Title or Position: CFO
Credential: P.T
Phone: 949-707-5555