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General NPI Number Information
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NPI Number | 1013576792
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Entity Type | Organization
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Legal Business Name | MOTION COMPLEX REHAB
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/10/2019
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Provider Practice Location Address
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Address Line | 555 W LAMBERT RD STE L
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City | BREA
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State | CA
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Zip | 92821-3917
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Country | US
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Telephone | 558-255-2598
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Fax | 855-825-4266
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Provider Business Mailing Address
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Address Line | 555 W LAMBERT RD STE L
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City | BREA
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State | CA
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Zip | 92821-3917
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Country | US
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Telephone | 714-869-4618
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Fax | 855-825-4266
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Authorized Official
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Title or Position | OWNER
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Name | JOHN ROOPKUMAR AMIRTHIAH
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Credential |
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Telephone | 855-825-5259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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