Healthcare Provider Details

I. General information

NPI: 1174933493
Provider Name (Legal Business Name): CENTERS OF REHABILITATION & PAIN MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 E YORBA LINDA BLVD STE 210
PLACENTIA CA
92870-3728
US

IV. Provider business mailing address

1041 E YORBA LINDA BLVD STE 210
PLACENTIA CA
92870-3728
US

V. Phone/Fax

Practice location:
  • Phone: 714-223-7000
  • Fax: 714-223-7001
Mailing address:
  • Phone: 714-223-7000
  • Fax: 714-223-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateCA

VIII. Authorized Official

Name: ALBERT LAI
Title or Position: AUTHORIZED OFFICIAL
Credential: M.D.
Phone: 714-223-7000