Matrix Rehabilitation, Inc.

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

MATRIX REHABILITATION, INC.

Doing business as

Select Physical Therapy

Practice address

30112 Crown Valley Pkwy
Laguna Niguel, CA 92677-2042

Phone

(949) 363-7716

Fax

(949) 363-1244

NPI assigned

Jun 13, 2006

Organization subpart

No

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

Authorized official

Name

Michael E. Tarvin

Title

Vice President

Phone

(717) 972-1100

Specialties & licenses 1

Addresses

Other names 1

• Select Physical Therapy Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Matrix Rehabilitation, Inc.

  • Rehabilitation Clinic/Center
  • Fountain Valley, CA
  • NPI 1174568539

  Member Of

  NPD member

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540512000000",
    "number": "1700828571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30112 CROWN VALLEY PKWY",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772042",
            "telephone_number": "949-363-7716",
            "fax_number": "949-363-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2018-10-26",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Select Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bijan Mashouf, M.D.
• Kian Masoumi, RDHAP
• Makenzie Massey
• John Henry Massimino, M.D.
• Melissa Ann Mathes, RDN
• Yulia Mazur
• Kara Melanie McCann, LMFT
• Barbara Vickers McCrory, OTR/L
• Julia Grace McDonnell, LMFT
• Natalie P McFarlane

• Rehabilitation Clinic/Center in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.