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General NPI Number Information
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NPI Number | 1114978830
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Entity Type | Organization
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Legal Business Name | CALIFORNIA REHABILITATION & SPORTS THERAPY A CALIFORNIA PHYSICAL THER
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 2101 E 4TH ST #170
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City | SANTA ANA
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State | CA
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Zip | 92705-3814
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Country | US
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Telephone | 714-558-3977
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Fax | 714-558-0308
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Provider Business Mailing Address
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Address Line | 2600 DALLAS PKWY STE 290
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City | FRISCO
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State | TX
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Zip | 75034-7493
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Country | US
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Telephone | 945-050-0010
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Fax | 949-644-0316
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Authorized Official
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Title or Position | COO
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Name | ROBERT PACE
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Credential |
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Telephone | 213-804-1712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 20582
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License Number State | CA
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