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General NPI Number Information
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NPI Number | 1942629605
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE REHAB
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Dates
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Enumeration Date | 04/10/2014
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Last Update Date | 04/10/2014
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Provider Practice Location Address
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Address Line | 8950 W OLYMPIC BLVD STE 373
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3565
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Country | US
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Telephone | 310-916-7177
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Fax | 323-214-7938
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Provider Business Mailing Address
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Address Line | 8950 W OLYMPIC BLVD STE 373
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3565
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Country | US
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Telephone | 310-916-7177
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Fax | 323-214-7938
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. ELMAR HEIMANSON
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Credential | RN
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Telephone | 310-916-7177
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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 | A40748
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License Number State | CA
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