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General NPI Number Information
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NPI Number | 1740292887
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Entity Type | Organization
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Legal Business Name | RYAN'S REHAB, INC
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 25706 HOOD WAY
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City | STEVENSON RANCH
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State | CA
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Zip | 91381-1403
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Country | US
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Telephone | 818-402-2132
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Fax |
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Provider Business Mailing Address
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Address Line | 25706 HOOD WAY
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City | STEVENSON RANCH
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State | CA
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Zip | 91381-1403
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Country | US
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Telephone | 818-402-2132
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KHURSHID K DASTUR-ESCALANTE
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Credential | OT
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Telephone | 818-402-2132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT2305
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License Number State | CA
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