NPIMap

Organization Active NPI

Gateway Rehab & Wellness Center, Inc.

  • Specialist
  • Mission Viejo, CA
National Provider Identifier
1184746927
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G060299 Issued in CA
Legal business name
GATEWAY REHAB & WELLNESS CENTER, INC.
Practice address
24002 Via Fabricante
Suite 501
Mission Viejo, CA 92691-3901
Phone
(949) 454-8811
Fax
(949) 454-8833
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Authorized official

Name
Dr. Victor Robert Rafa, D.C.NPI 1952423618
Title
President
Phone
(949) 454-8811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC-28755 CA
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC-28726 CA
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G060299 CA Primary

Addresses

Primary practice location

24002 Via Fabricante
Suite 501
Mission Viejo, CA 92691-3901

Mailing address

24002 Via Fabricante
Suite 501
Mission Viejo, CA 92691-3901
Phone (949) 454-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100416000619 CA Part B Supplier - Clinic/Group Practice 7517094980 Receives reassigned benefits from 10 practitioners
Practice locations: Mission Viejo, CA
O20170815001779 CA DME Supplier - Physician - Physical and RehabilitationDME Supplier - Independently-Practicing Physical Therapist 7517094980 Practice locations: Mission Viejo, CA

National Provider Directory

National Provider Directory

Locations

325 Old Newport Blvd
Ste 3
Newport Beach, CA 92663
Phone (949) 650-1228

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1184746927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24002 VIA FABRICANTE",
            "address_2": "SUITE 501",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926913901",
            "telephone_number": "949-454-8811",
            "fax_number": "949-454-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24002 VIA FABRICANTE",
            "address_2": "SUITE 501",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926913901",
            "telephone_number": "949-454-8811",
            "fax_number": "949-454-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY REHAB & WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "RAFA",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-454-8811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-28755",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-28726",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G060299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.