Organization Active NPI

Socal Rehab Consultants Inc

  • Physical Medicine & Rehabilitation Physician
  • San Bernardino, CA
National Provider Identifier
1780182816
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SOCAL REHAB CONSULTANTS INC
Practice address
1760 W 16TH St
San Bernardino, CA 92411-1160
Phone
(909) 529-6921
Fax
(951) 688-1432
NPI assigned
Jan 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Authorized official

Name
Ann Montes
Title
Office Administrator
Phone
(951) 310-8232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1760 W 16TH St
San Bernardino, CA 92411-1160

Mailing address

25612 Barton Rd Ste 266
Loma Linda, CA 92354-3110
Phone (909) 529-6921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180321002347 CA Part B Supplier - Clinic/Group Practice 7416219928 Receives reassigned benefits from 1 practitioner
Practice locations: Redlands, CA

National Provider Directory

National Provider Directory

Locations

105 Terracina Blvd
Redlands, CA 92373
Phone (909) 793-2271

1620 W Fern Ave
Redlands, CA 92373
Phone (909) 793-2196

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1780182816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25612 BARTON RD STE 266",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543110",
            "telephone_number": "909-529-6921",
            "fax_number": "951-688-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 W 16TH ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111160",
            "telephone_number": "909-529-6921",
            "fax_number": "951-688-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL REHAB CONSULTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "MONTES",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "951-310-8232"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.