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General NPI Number Information
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NPI Number | 1669005799
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Entity Type | Organization
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Legal Business Name | VISALIA REHAB GROUP INC
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 840 S AKERS ST
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City | VISALIA
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State | CA
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Zip | 93277-8309
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Country | US
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Telephone | 808-391-6419
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Fax |
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Provider Business Mailing Address
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Address Line | 2808 N QUINCY ST
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City | VISALIA
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State | CA
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Zip | 93291-8523
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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 | PRESIDENT
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Name | DR. SAMUEL MATSUO JR.
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Credential | MD
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Telephone | 808-391-6419
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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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