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General NPI Number Information
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NPI Number | 1184187601
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Entity Type | Organization
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Legal Business Name | SOCAL REHAB ALLIANCE LLC
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 17272 NEWHOPE ST #G
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708
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Country | US
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Telephone | 949-322-7307
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Fax | 714-434-7042
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Provider Business Mailing Address
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Address Line | P.O. BOX 8125
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92728-8125
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Country | US
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Telephone | 949-322-7307
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN R HORSLEY
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Credential | PT
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Telephone | 714-754-7268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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