MEDICARE: ADVANCED REHAB THERAPY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	28882	CA
2	261QP2000X	Physical Therapy Clinic/Center	28882	CA

General Provider Information

NPI Number	:	1538436829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED REHAB THERAPY INC.

Provider Business Mailing Address
First Line	:	1230 IVY TER
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90502-1603
Country	:	US
Telephone Number	:	800-659-9311
Fax Number	:	562-989-6516

Provider Business Practice Location Address
First Line	:	14708 HAWTHORNE BLVD
Second Line	:
City	:	LAWNDALE
State	:	CA
Zip	:	90260-1523
Country	:	US
Telephone Number	:	800-659-9311
Fax Number	:	562-989-6516

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. HENRICK MACALINTAL
Credential	:
Telephone Number	:	424-675-4958

Provider Enumeration Date	:	11/30/2011
Last Update Date	:	11/01/2017

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