MEDICARE: REHAB LABS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	133NN1002X	Nutrition Education Nutritionist
2	171100000X	Acupuncturist
3	171400000X	Health & Wellness Coach
4	251V00000X	Voluntary or Charitable Agency
5	261QC1500X	Community Health Clinic/Center
6	261QP2000X	Physical Therapy Clinic/Center
7	261QP3300X	Pain Clinic/Center
8	261QR1100X	Research Clinic/Center
9	261QR1300X	Rural Health Clinic/Center
10	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1841920253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB LABS

Provider Business Mailing Address
First Line	:	38292 WILD POPPY LN
Second Line	:
City	:	YUCAIPA
State	:	CA
Zip	:	92399-9449
Country	:	US
Telephone Number	:	909-553-9424
Fax Number	:	949-269-0672

Provider Business Practice Location Address
First Line	:	72855 FRED WARING DR STE C20
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-9372
Country	:	US
Telephone Number	:	760-404-0360
Fax Number	:	949-269-0672

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DINORA NAVA OLESON
Credential	:
Telephone Number	:	909-553-9424

Provider Enumeration Date	:	06/16/2022
Last Update Date	:	08/22/2022

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Directions to “REHAB LABS ” Practice Location

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