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General NPI Number Information
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NPI Number | 1801430061
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Entity Type | Organization
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Legal Business Name | ADVANCE REHAB SERVICES, INC
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Dates
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Enumeration Date | 10/31/2019
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 350 NUGGET CT
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City | SAN DIMAS
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State | CA
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Zip | 91773-2312
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Country | US
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Telephone | 818-314-5774
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Fax | 818-484-2146
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Provider Business Mailing Address
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Address Line | 350 NUGGET CT
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City | SAN DIMAS
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State | CA
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Zip | 91773-2312
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Country | US
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Telephone | 818-314-5774
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Fax | 818-484-2146
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANOJ K PARIDA
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Credential | OTR
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Telephone | 818-314-5774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251H1300X
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Taxonomy Name | Human Factors Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225XH1300X
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Taxonomy Name | Human Factors Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number |
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License Number State |
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