NPIMap

Organization Active NPI

California Rehabilitation & Sports Therapy a California Physical Ther

  • Multi-Specialty Clinic/Center
  • San Clemente, CA
National Provider Identifier
1023614419
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CALIFORNIA REHABILITATION & SPORTS THERAPY A CALIFORNIA PHYSICAL THER
Practice address
415 E Avenida Pico
San Clemente, CA 92672-3800
Phone
(949) 245-6581
Fax
(949) 688-2136
NPI assigned
Dec 10, 2020
Last updated
Feb 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert PaceNPI 1164643466
Title
Owner
Phone
(213) 804-1712

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

415 E Avenida Pico
San Clemente, CA 92672-3800

Mailing address

2600 Dallas Pkwy Ste 290
Frisco, TX 75034-7493
Phone (945) 050-0010

Other names 1

  • California Rehab and Sports Therapy Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120001115 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6709788896 Receives reassigned benefits from 274 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Long Beach, CA; Mission Viejo, CA; Newport Beach, CA; Northridge, CA; Norwalk, CA; Orange, CA; Rancho Mission Viejo, CA; Rancho Santa Margarita, CA…

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory
Tax ID family
California Rehab Sports28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

415 E Avenida Pico
San Clemente, CA 92672
Phone (949) 245-6581

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1023614419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 DALLAS PKWY STE 290",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347493",
            "telephone_number": "945-050-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E AVENIDA PICO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723800",
            "telephone_number": "949-245-6581",
            "fax_number": "949-688-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA REHABILITATION & SPORTS THERAPY A CALIFORNIA PHYSICAL THER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-10",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-804-1712"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Rehab and Sports Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.