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General NPI Number Information
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NPI Number | 1134095623
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Entity Type | Organization
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Legal Business Name | PACIFIC COAST REHABILITATION AND PAIN MANAGEMENT
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 7510 CLAIREMONT MESA BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92111-1539
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Country | US
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Telephone | 310-596-5994
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Fax |
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Provider Business Mailing Address
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Address Line | 1822 E ROUTE 66 STE A
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City | GLENDORA
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State | CA
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Zip | 91740-3800
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | RISHI SHAH
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Credential | MD
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Telephone | 630-418-1799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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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 | 2081H0002X
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Taxonomy Name | Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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