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General NPI Number Information
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NPI Number | 1619355609
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Entity Type | Organization
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Legal Business Name | PURE ABILITY MEDICINE & REHABILITATION, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 05/11/2015
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Provider Practice Location Address
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Address Line | 5001 COMMERCE DR
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0648
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Country | US
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Telephone | 661-323-5500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12575
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City | BAKERSFIELD
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State | CA
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Zip | 93389-2575
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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
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Name | DR. MICHAEL LEE
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Credential | M.D.
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Telephone | 626-641-6499
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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 | A133798
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License Number State | CA
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