Nifty After Fifty - Prospect, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT29179 Issued in CA

Legal business name

NIFTY AFTER FIFTY - PROSPECT, LLC

Practice address

11021 Brookhurst St
Suite a
Garden Grove, CA 92840-1001

Phone

(714) 823-4400

Fax

(714) 823-4404

NPI assigned

Jun 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sheldon S. Zinberg, M.D.

Title

Ceo

Phone

(714) 823-4400

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396949459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12572 VALLEY VIEW ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928452006",
            "telephone_number": "714-823-4400",
            "fax_number": "714-823-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11021 BROOKHURST ST",
            "address_2": "SUITE A",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928401001",
            "telephone_number": "714-823-4400",
            "fax_number": "714-823-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIFTY AFTER FIFTY - PROSPECT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZINBERG",
        "authorized_official_first_name": "SHELDON",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-823-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT7788",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT11479",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT22690",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT28267",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT29179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Marie Nicholson
• Janis Niemann, M.S., BCBA
• Rebecca Lynn Niemeyer
• Oscar Eduardo Nieto
• Nifty After Fifty
• Monica Nino
• Jeremy Nishimoto
• Valeria Moreno Fernandez Noel, MA, BCBA
• Michelle Noertker
• Jae Min Noh, L.AC.

• Physical Medicine & Rehabilitation Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.