Healthcare Provider Details

I. General information

NPI: 1366614695
Provider Name (Legal Business Name): RSG REHAB TEAM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13821 SAN ANTONIO DR
NORWALK CA
90650-4034
US

IV. Provider business mailing address

3846 DIVISION ST
LOS ANGELES CA
90065-4245
US

V. Phone/Fax

Practice location:
  • Phone: 562-863-4330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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

VIII. Authorized Official

Name: MR. DANNIEL EMPE GOYENA
Title or Position: PRESIDENT
Credential:
Phone: 213-590-3246