MEDICARE: MEDICAL REHABILITATION THERAPY CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	226300000X	Kinesiotherapist
2	251T00000X	PACE Provider Organization
3	253Z00000X	In Home Supportive Care Agency
4	261Q00000X	Clinic/Center
5	261QP2000X	Physical Therapy Clinic/Center
6	261QP3300X	Pain Clinic/Center
7	261QR0400X	Rehabilitation Clinic/Center
8	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)
9	261QS1000X	Student Health Clinic/Center
10	261QU0200X	Urgent Care Clinic/Center
11	347C00000X	Private Vehicle
12	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1699592782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL REHABILITATION THERAPY CENTER

Provider Business Mailing Address
First Line	:	1805 W AVENUE K STE 100
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-5925
Country	:	US
Telephone Number	:	323-641-3009
Fax Number	:

Provider Business Practice Location Address
First Line	:	1805 W AVENUE K STE 100
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-5925
Country	:	US
Telephone Number	:	661-367-1433
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FABION MCGHEE
Credential	:	THERAPEUTIC
Telephone Number	:	323-641-3009

Provider Enumeration Date	:	09/20/2024
Last Update Date	:	11/04/2024

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Directions to “MEDICAL REHABILITATION THERAPY CENTER ” Practice Location

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