NPIMap

Organization Active NPI

Pristine Rehab Care

  • Early Intervention Provider Agency
  • Diamond Bar, CA
National Provider Identifier
1093046286
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
PRISTINE REHAB CARE
Practice address
706 N Diamond Bar Blvd Ste B
Diamond Bar, CA 91765-1059
Phone
(909) 396-8900
Fax
(909) 396-9900
NPI assigned
Jan 27, 2010
Last updated
Nov 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2010

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

Authorized official

Name
Mr. Kishore Kantamaneni
Title
President
Phone
(909) 396-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X CA Primary

Addresses

Primary practice location

706 N Diamond Bar Blvd Ste B
Diamond Bar, CA 91765-1059

Mailing address

706 N Diamond Bar Blvd Ste B
Diamond Bar, CA 91765-1059
Phone (909) 396-8900

National Provider Directory

National Provider Directory

Locations

706 N Diamond Bar Blvd
Ste B
Diamond Bar, CA 91765
Phone (909) 396-8900

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288742400000",
    "number": "1093046286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 N DIAMOND BAR BLVD STE B",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651059",
            "telephone_number": "909-396-8900",
            "fax_number": "909-396-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 N DIAMOND BAR BLVD STE B",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651059",
            "telephone_number": "909-396-8900",
            "fax_number": "909-396-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE REHAB CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-11-03",
        "status": "A",
        "authorized_official_last_name": "KANTAMANENI",
        "authorized_official_first_name": "KISHORE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-396-8900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.