Provider Demographics
NPI:1053347369
Name:REHABILITATION ASSOCIATES PTR
Entity type:Organization
Organization Name:REHABILITATION ASSOCIATES PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-424-8111
Mailing Address - Street 1:2840 LONG BEACH BLVD
Mailing Address - Street 2:130
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1516
Mailing Address - Country:US
Mailing Address - Phone:562-424-8111
Mailing Address - Fax:562-492-6830
Practice Address - Street 1:2840 LONG BEACH BLVD
Practice Address - Street 2:130
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1516
Practice Address - Country:US
Practice Address - Phone:562-424-8111
Practice Address - Fax:562-492-6830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW837Medicare PIN