Performance Care Sports Medicine & Rehabilitation Center, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A42627 Issued in CA

Legal business name

PERFORMANCE CARE SPORTS MEDICINE & REHABILITATION CENTER, INC.

Practice address

10738 Riverside Drive, Suite a
Toluca Lake, CA 91602-2372

Phone

(818) 766-4307

Fax

(818) 766-4309

NPI assigned

Jun 5, 2009

Last updated

Nov 20, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Golan Nissim, DCNPI 1932270147

Title

VP

Phone

(818) 766-4307

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 4

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.

• Golan Nissim, D.C., A.R.T., Q.M.E.

  • Chiropractor
  • Toluca Lake, CA
  • NPI 1932270147
  Medicare reassignment Care Compare group NPD Authorized official
• Jeko Behfarin, MD

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1689686875
  Medicare reassignment Care Compare group NPD
• Laura Kathleen Wilson, DPT

  • Physical Therapist
  • Toluca Lake, CA
  • NPI 1558537977
  Medicare reassignment Care Compare group NPD
• Zachary Ray, PT, SCS

  • Physical Therapist
  • Westlake Village, CA
  • NPI 1174853162
  Medicare reassignment NPD

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1487880399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10738 RIVERSIDE DR STE A",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022372",
            "telephone_number": "818-766-4307",
            "fax_number": "818-766-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10738 RIVERSIDE DRIVE, SUITE A",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022372",
            "telephone_number": "818-766-4307",
            "fax_number": "818-766-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE CARE SPORTS MEDICINE & REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-05",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "NISSIM",
        "authorized_official_first_name": "GOLAN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "818-766-4307",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25362",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A42627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Palmer, D.C.
• Don Alan Paxton, MD
• Pema Dental Care (toluca dental care)
• Nilesh Pema, DDS
• Cynthia Pendley, BSN, RN
• Shima Pezeshki, NP
• Jessyca R Phichit, MA, LPCC
• Plan B Marriage and Family Therapy, Prof. Corp.
• Premiere Medical Center of Burbank, Inc.
• Prime Podiatric Group, Inc

• Internal Medicine Physician in Toluca Lake, CA
• Providers in Toluca Lake, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.