MEDICARE: AGENCY REHAB, 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1962557942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGENCY REHAB, INC.

Provider Business Mailing Address
First Line	:	3248 E WILLOW ST
Second Line	:
City	:	SIGNAL HILL
State	:	CA
Zip	:	90755-2309
Country	:	US
Telephone Number	:	562-426-2051
Fax Number	:

Provider Business Practice Location Address
First Line	:	3311 E WILLOW ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-2310
Country	:	US
Telephone Number	:	562-426-2051
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KEVIN EUGENE SMITH
Credential	:
Telephone Number	:	562-426-2051

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	08/22/2020

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