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General NPI Number Information
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NPI Number | 1144460577
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Entity Type | Organization
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Legal Business Name | REHABNET OUTPATIENT CENTER
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 1260 15TH ST SUITE 900
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City | SANTA MONICA
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State | CA
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Zip | 90404-1135
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Country | US
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Telephone | 310-651-2292
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Fax | 310-451-2554
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Provider Business Mailing Address
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Address Line | 5966 JAMIESON AVE
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City | ENCINO
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State | CA
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Zip | 91316-1018
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Country | US
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Telephone | 818-344-6433
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | WENDY NORRIS
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Credential |
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Telephone | 310-451-2292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | OT 6103
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License Number State | CA
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