Healthcare Provider Details

I. General information

NPI: 1548754658
Provider Name (Legal Business Name): ACCESS REHAB PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 W ARROW HWY
SAN DIMAS CA
91773-2969
US

IV. Provider business mailing address

630 W ARROW HWY
SAN DIMAS CA
91773-2969
US

V. Phone/Fax

Practice location:
  • Phone: 909-592-2778
  • Fax: 909-592-2789
Mailing address:
  • Phone: 909-592-2778
  • Fax: 909-592-2789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateCA

VIII. Authorized Official

Name: ROGER D MAGSINO
Title or Position: OWNER
Credential: MPT
Phone: 626-665-2563