Provider Demographics
NPI:1679729339
Name:CALIFORNIA REHABILITATION EQUIPMENT, INC.
Entity type:Organization
Organization Name:CALIFORNIA REHABILITATION EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-402-8393
Mailing Address - Street 1:1172 NATIONAL DR
Mailing Address - Street 2:SUITE 90
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-2949
Mailing Address - Country:US
Mailing Address - Phone:916-419-2264
Mailing Address - Fax:
Practice Address - Street 1:1172 NATIONAL DR
Practice Address - Street 2:SUITE 90
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-2949
Practice Address - Country:US
Practice Address - Phone:916-419-2264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ73552ZMedicaid
CA0184280001Medicare NSC