Extreme Performance and Rehabilitation,LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

3395 Issued in AZ

Legal business name

EXTREME PERFORMANCE AND REHABILITATION,LLC

Practice address

2205 W 23Rd St Ste a
Yuma, AZ 85364-8869

Phone

(928) 446-3473

NPI assigned

Sep 29, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Oscar Esqueda Jr., P.T.

Title

Owner/Manager

Phone

(928) 446-3473

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1790935567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 W 23RD ST STE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648869",
            "telephone_number": "928-446-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 W 23RD ST STE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648869",
            "telephone_number": "928-446-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTREME PERFORMANCE AND REHABILITATION,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-29",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "ESQUEDA",
        "authorized_official_first_name": "OSCAR",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "928-446-3473",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "AZ",
            "license": "3395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.