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General NPI Number Information
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NPI Number | 1083085278
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Entity Type | Organization
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Legal Business Name | CALIFORNIA REHAB & SPORTS THERAPY
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 5962 LA PLACE CT # 150
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City | CARLSBAD
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State | CA
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Zip | 92008-8807
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Country | US
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Telephone | 760-607-9679
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Fax | 760-602-3273
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Provider Business Mailing Address
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Address Line | 5962 LA PLACE CT # 150
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City | CARLSBAD
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State | CA
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Zip | 92008-8807
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Country | US
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Telephone | 760-607-9679
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Fax | 760-602-3273
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Authorized Official
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Title or Position | VP RCM
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Name | MR. JONATHAN EARL DOCKERY
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Credential |
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Telephone | 760-607-9679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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