Healthcare Provider Details

I. General information

NPI: 1902350432
Provider Name (Legal Business Name): REGIN OKUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2016
Last Update Date: 08/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 SCOTTSDALE RD
PLEASANT HILL CA
94523-5117
US

IV. Provider business mailing address

355 SCOTTSDALE RD
PLEASANT HILL CA
94523-5117
US

V. Phone/Fax

Practice location:
  • Phone: 415-652-0182
  • Fax:
Mailing address:
  • Phone: 415-652-0182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License NumberOT14617
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: