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General NPI Number Information
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NPI Number | 1255986873
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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 | 08/09/2019
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 255 E RINCON ST STE 112
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City | CORONA
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State | CA
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Zip | 92879-1375
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Country | US
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Telephone | 951-523-8509
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Fax | 951-221-8475
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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 |
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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 | PT
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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